I have only got round this a couple of times, and most often when the client has been Orthopaedic Surgeon referred, and lived a distance away. I argued that my one hour appointments where cheaper than two half hour appointments and they got paid by the health insurance company. However, I did have to have support from the surgeon. In general I usually do longer rehab appointments, but overlap these appoitments with other clients, so the client is working away in the background, with me popping in and out on rehab while I'm one to one with someone else. I then see them one to one for 20 mins so that the whole counts as a single consultation.
I find my normal consultation time is 40 mins and my rehab appoints last 1 hour. However I always charge for 30 mins.
Have you read my post on the refer and do not refer guidelines ? I would appreciate your comments