What is the 97110 CPT code?
Asked by: Miss Gudrun Witting | Last update: January 16, 2026Score: 4.9/5 (73 votes)
What is the medical necessity for 97110?
To bill using the 97110 CPT code, the exercises prescribed must be medically necessary to enhance a patient's mobility and strength, thus increasing participation in daily activities like feeding, dressing, bathing, and various other functional tasks.
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 a physical exam?
CPT® Code 2040F - Physical Examination - Codify by AAPC.
What is the difference between 97140 and 97110?
CPT code 97140 is used for skilled manual therapy techniques with no additional activities simultaneously occurring. If therapeutic, resistive, or strengthening exercises are included in combination with manual techniques, these activities fall under CPT code 97110, therapeutic exercise.
CPT Code 97110 vs CPT Code 97530 | Medicare Billing & Documentation
What is CPT code 97110 used for?
CPT 97110: Therapeutic Exercise
CPT code 97110 is defined as “therapeutic exercises to develop strength, endurance, range of motion and flexibility.” It applies to a single or multiple body parts, and requires direct contact with a qualified healthcare professional.
Can 97110 and 97140 be billed together?
Since the time for each service is the same, choose either code for 2 units and bill the other for 1 unit. Do not bill 3 units for either one of the codes. Appropriate billing for 40 minutes is for 3 units. Bill 2 units of 97110 and 1 unit of 97140.
What is the modifier for 97110 CPT code?
Modifier to CPT 97110
Services would typically be documented with the GP modifier, reflecting a service that is unique in terms of skills and knowledge for a physical therapist. Take note that the GP modifier is used in cases where the services are provided under an outpatient physical therapy plan of care.
What is the CPT code for adult well exam?
At ChartSpan, we provide eligibility checks for G0438 and G0439 — the core codes for Annual Wellness Visits.
What does CPT stand for?
The Current Procedural Terminology (CPT®) codes offer doctors and health care professionals a uniform language for coding medical services and procedures to streamline reporting, increase accuracy and efficiency.
Is CPT code 97140 physical therapy?
CPT® code 97140: Manual therapy techniques, 1 or more regions, each 15 minutes (Mobilization/manipulation, manual lymphatic drainage, manual traction)
What is considered medically necessary for physical therapy?
The definition of medical necessity in medical practice and physical therapy and occupational therapy refers to the requirement that a specific treatment or intervention is justified and essential to address a patient's illness, medical condition, or functional limitations.
How many units of 97110 can you bill?
How many units can you bill for CPT code 97110? CPT code 97110 is timed, billed one unit per 15 minutes, following the 8-minute rule as required per the insurance plan. Common reimbursement issues include mismatched time per unit or activity billed and missing documentation.
What is the new PT visit code?
9789.12. 11. Evaluation and Management: Coding - New Patient; Documentation.
What is not included in a wellness visit?
Your insurance for your annual wellness visit does not cover any discussion, treatment or prescription of medications for chronic illnesses or conditions, such as high blood pressure, high cholesterol or diabetes. In this instance as well, you will be charged a copay and/or a deductible.
What is the code for an annual physical exam?
An initial Annual Wellness Visit code is documented using G0438, subsequent Annual Wellness Visits are documented using code G0439. The Annual Routine Physical Exam allows members to seek a separate visit with their physician to discuss general health questions/issues without presenting a specific chief complaint.
What is the CPT code for female wellness exam?
Preventive medicine codes (99381–99387 and 99391–99397) are used to report annual well-woman examinations and determined by the age of the patient and whether she is considered a new or established patient to the physician or practice.
What does CPT code 97110 stand for?
CPT® code 97110: Therapy procedure using exercise to develop strength, endurance, range of motion and flexibility, each 15 minutes.
What documentation is needed for 97110?
Documentation should include not only measurable indicators such as functional loss of joint motion or muscle strength, but also information on the impact of these limitations on the patient's life and how improvement in one or more of these measures leads to improved function.
How much is the CPT code 97110?
97110 $75/unit Therapeutic Exercises Therapeutic exercises to develop strength, endurance, range of motion and flexibility. It applies to a single or multiple body parts, and requires direct contact with a qualified healthcare professional.
Is manual therapy the same as physical therapy?
Manual therapy is a specialty within the field of physical therapy. Traditional physical therapy focuses more on managing and treating the symptoms of the disease process, while manual therapy focuses more on performing biomechanical, tissue-based examination to identify the cause of the disease process.
What requirements are necessary for a consultation?
CPT® defines a consultation as “a type of service provided by a physician whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician or other appropriate source.” To substantiate a consultation service, documentation must include three elements: a request, a ...
What modifier is needed for 97110?
Modifiers GP(Outpatient Physical Therapy), GO (Outpatient Occupational Therapy), GN (Outpatient Speech-Language Pathology), CO (Outpatient Occupational Therapy by an Occupational Therapy Assistant (completely or partially)), CQ (Outpatient Physical Therapy by a Physical Therapist Assistant (completely or partially)), ...