Covered Services: Time-Based Services
When a covered service is set to Time-Based, Doulado calculates billing units using the Medicaid 8-Minute Rule.
This rule determines how many billable units can be submitted based on the total duration of a visit.
Under the 8-Minute Rule, units are calculated in 15-minute increments using the following formula:
Units = round( (minutes + 7) ÷ 15 )
|
Visit Duration |
Unit |
|---|---|
|
8-22 minutes |
1 Unit |
|
23–37 minutes |
2 Units |
|
38-52 minutes |
3 Units |
|
53-67 minutes |
4 Units |
When a claim is created from a visit and a Time-Based service is added, Doulado automatically uses the visit duration to calculate the correct number of units.
Example
If a visit lasts 60 minutes, the calculation would be:
(60 + 7) ÷ 15 = 4.46 → rounds to 4 units
The claim will automatically populate with 4 billable units for that service.
This automation helps ensure accurate billing and supports payer requirements that follow the Medicaid 8-Minute Rule.