Service Units vs Units

  • 1 Unit = 1 Appointment
    • Units provide a way of applying a multiple to a primary code. They should be listed as 1 service unit for billing purposes unless indicated in CPT guidelines for that service or time based codes. If you increase the amount of units the charge associated with the primary code will be multiplied.
    • Units would be for example with testing, where you have a testing code that’s 15 minutes & then you schedule/bill 4 units of that for 1 hour total appointment. The charge amount is multiplied by the units for billing purposes.
  • Service Units= the appointment “weight”
    • Service Units are used for productivity reporting and are defined at the procedure code level (Transaction Codes | Procedures)
    • For example, maybe for your organization 90837/60min psychotherapy is considered 1 unit. You could then weight 90834/45min as .75 service units and maybe 90791 as 1.5 service units.
    • Service units allow your organization to define the relative amount of work different types of services require from your providers.

The “Units” field on the appointment only applies to the primary code. Units for add-on codes default to 1. If Units need to be adjusted for an add-on code, that can be done via View/Edit Charges once the appointment is recorded and processed through the PTQ.

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