What are CPT codes for physical therapy?
Asked by: Prof. Joanie Yost III | Last update: February 3, 2025Score: 4.8/5 (47 votes)
- Code 97110: Therapeutic exercise.
- Code 97112: Neuromuscular re-education.
- Code 97140: Manual therapy.
- Code 97035: Ultrasound therapy.
- Code 97014: Electrical stimulation.
Where can I get a list of CPT codes?
The Centers for Medicare & Medicaid Services offer a free search (CPT code lookup) for RVU for every CPT code. Users can also request a CPT/RVU Data File license from the AMA to easily import codes and descriptions into existing claims and medical billing systems.
What is the difference between CPT 97110 and 97112?
Let's take a look at the three most common CPT codes for Physical Therapy and Occupational Therapy, and how to properly document them for reimbursement. Keep reading for a detailed summary of CPT 97110: Therapeutic Exercise, CPT 97112: Therapeutic Procedure (stroke and non-stroke), and 97530 Therapeutic Activities.
What are CPT codes for therapy sessions?
CPT Codes 90832-90838 represent psychotherapy. Psychotherapy without medical evaluation and management services are reported as 90832, 90834 and 90837. Psychotherapy with medical evaluation and management services are reported with codes for E/M services plus a psychotherapy add-on code (90833; 90836; 90838).
What is the difference between CPT code 90834 and 90837?
90834: This code is used for sessions lasting between 38 and 52 minutes, falling within the commonly referred to "45-minute" therapy session range. 90837: This code is reserved for longer sessions, lasting 53 minutes or more, often referred to as "60-minute" sessions.
Physical Therapy Billing Codes
What are the new CPT codes for physical therapy 2024?
- CPT Code 97032 – Electrical Stimulation. ...
- CPT Code 97110 – Therapeutic Exercise. ...
- CPT Code 97112 – Neuromuscular Re-education. ...
- CPT Code 97116 – Gait Training. ...
- CPT Code 97140 – Manual Therapy. ...
- CPT Code 97150 – Group Therapy. ...
- CPT Code 97530 – Therapeutic Activities.
How is physical therapy billed?
Each healthcare industry uses different medical billing services and codes. However, the fields of physical and occupational therapy generally use the same standardized unit-based system for billing patients. In this system, each unit represents the specific amount of time the therapist spent providing treatment.
What are ICD-10 codes for physical therapy?
- R26. 2 – Difficulty in walking, not elsewhere classified.
- M54. 5 – Low back pain.
- M62. 81 – Muscle weakness (generalized)
- M25. 512 – Pain in left shoulder.
What is the CPT code 97110 for physical therapy?
CPT® code 97110: Therapy procedure using exercise to develop strength, endurance, range of motion and flexibility, each 15 minutes.
What is CPT code 97012 for physical therapy?
CPT Code 97012 refers to mechanical traction, a therapeutic procedure that involves the use of mechanical force to stretch and mobilize specific body parts, typically the spine, to relieve pain, improve mobility, and enhance the flexibility of connective tissues.
What is the CPT code for physical medicine and rehabilitation?
Physical Medicine and Rehabilitation Evaluations CPT® Code range 97010- 97799. The Current Procedural Terminology (CPT) code range for Physical Medicine and Rehabilitation Evaluations 97010-97799 is a medical code set maintained by the American Medical Association.
What is the CPT code for self-care physical therapy?
CPT code 97535 is used by occupational therapists to indicate billing for training for self-care, home management, ADLs, compensatory training, safety procedures, and incorporating assistive devices into a routine.
How to find a CPT code?
Complete code lists (electronic and hard copies) are for purchase only. However, the American Medical Association website includes a CPT code search tool. Researchers can search by the 5 digit CPT code or a keyword to identify codes and/or definitions.
Is there a CPT code for physical therapy?
97110: Therapeutic exercise
These exercises are used to improve strength, endurance, range of motion, and flexibility; their goal is to restore physical function. It's perfect for exercises that are directly related to the client's diagnosis and are part of a planned treatment.
What is the 15 minute rule for physical therapy?
To calculate the number of billable units for a date of service, providers must add up the total minutes of skilled, one-on-one therapy and divide that total by 15. If eight or more minutes remain, you can bill one more unit. Otherwise, you cannot.
Do you pay a copay every visit for physical therapy?
Most insurance companies cover a portion of the physical therapy bill and leave the rest for you to cover with a copay. This payment will need to be made for every PT session you attend. Ask your insurance company about your financial responsibility for PT before you make your first appointment.
What are CPT codes?
Current Procedural Terminology (CPT®) codes provide a uniform nomenclature for coding medical procedures and services. Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guid ...Read More.
How many times a week will Medicare pay for physical therapy?
There is not a set number of visits that you are allowed by Medicare per year. Instead, it's determined by medical necessity. There are a number of factors that must be present in order to prove medical necessity.
What is the difference between CPT code 97110 and 97530?
To use this code, it is necessary for the provider to be present with the patient for the entire session, in an active, active-assisted, or passive role. The major difference between CPT 97110 and 97530 is the number of target areas being addressed during the activity.
What is the CPT code for therapy?
Outpatient Mental Health CPT Codes:
90832 – Psychotherapy, 30 minutes (16-37 minutes). 90834 – Psychotherapy, 45 minutes (38-52 minutes). 90837 – Psychotherapy, 60 minutes (53 minutes and over).
Can I bill 90837 for 50 minutes?
Time Requirements and Service Criteria for Billing 90837
Code 90837 is for 60-minute therapy sessions, defined as 53 minutes or longer. Anything less than 53 minutes would use code 90834 (45-minute session). For 90837, the actual session time must be documented in your notes. Rounding up or down is not allowed.
What is CPT code 99214?
CPT® code 99214: Established patient office or other outpatient visit, 30-39 minutes. As the authority on the CPT® code set, the AMA is providing the top-searched codes to help remove obstacles and burdens that interfere with patient care.