CPT coding isn’t what therapists went to school for. But it is one of the most common — and costly — areas of compliance risk in private practice.

In this episode of the Compliance Series, Adam Robin sits down with compliance expert Daniel Hirsch from Risk & Compliance Analytics to break down how CPT codes should actually be used — and why most audit problems aren’t caused by fraud… but by bad habits, unclear documentation, and misunderstood workflows.

This is a fast-paced, practical conversation about how to stay audit-ready without drowning your therapists in unnecessary documentation.

They unpack:

• Why CPT coding is one of the highest-risk audit triggers
• The three questions auditors always ask
• Why “medically necessary” and “skilled” must be clearly documented
• hy total treatment time doesn’t automatically equal billable time
• The biggest mistakes with time-based CPT codes
• How lumping treatment together creates audit exposure
• Why cloning notes and identical documentation raise red flags
• The power of one strong assessment sentence
• Why therapists often underbill — not overbill
• How AI tools may improve justification clarity
• Why chasing higher-paying codes can backfire
• The single most important rule when billing time-based codes

Daniel also explains why auditors aren’t trying to “catch” you — they’re simply looking for consistency, progression, and clinical reasoning that supports skilled care.

If you want to protect your clinic, defend your billing, and build documentation that survives scrutiny — without overwhelming your team — this episode is essential listening.

🎯 Takeaway: CPT codes aren’t about listing tasks. They’re about telling the story of why your clinical brain was necessary.

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