Therapeutic Procedures

These codes are used for treatments that require direct patient contact by the therapist. They are typically billed in 15-minute increments.

• 97110: Therapeutic Exercise
  Exercises to develop strength, endurance, range of motion, and flexibility.
• 97112: Neuromuscular Re-education
  Activities to improve balance, coordination, posture, and proprioception.
• 97113: Aquatic Therapy with Therapeutic Exercise
  Exercise performed in water for resistance.
• 97116: Gait Training Therapy
  Training to improve walking ability.
• 97124: Massage Therapy
  Effleurage, petrissage, and/or tapotement (stroking, compression, percussion).
• 97140: Manual Therapy Techniques
  Mobilization, manipulation, manual lymphatic drainage, and manual traction.
• 97530: Therapeutic Activities
  Dynamic activities to improve functional performance.
• 97533: Sensory Integration Techniques
  Therapeutic techniques for sensory processing issues.
• 97535: Self-care/Home Management Training
  Training for activities of daily living (ADLs) and compensatory training.
• 97537: Community/Work Reintegration Training
  Training in work, community, and leisure environments.
• 97542: Wheelchair Management/Training
  Assessment, fitting, and training in the use of a wheelchair.

Evaluations and Re-evaluations

These codes are used for the assessment and evaluation of patients by the therapist.

• 97161: Physical Therapy Evaluation: Low Complexity
  Involves a history with no personal factors and/or comorbidities affecting the plan of care.
• 97162: Physical Therapy Evaluation: Moderate Complexity
  Involves a history with 1-2 personal factors and/or comorbidities affecting the plan of care.
• 97163: Physical Therapy Evaluation: High Complexity
  Involves a history with 3 or more personal factors and/or comorbidities affecting the plan of care.
• 97164: Re-evaluation of Physical Therapy
  Re-assessment of patient status, plan of care modification.

Physical Performance Tests and Measurements

These codes cover tests that assess physical performance and capabilities.

• 97750: Physical Performance Test or Measurement
  Includes functional capacity evaluations.
• 97755: Assistive Technology Assessment
  Assessment for the selection of an assistive technology device.

Wound Management

Codes for physical therapy procedures related to wound care.

• 97597: Debridement (Initial 20 Sq Cm or Less)
  Removal of devitalized tissue from a wound.
• 97598: Debridement (Each Additional 20 Sq Cm)
  Additional debridement of devitalized tissue.

Other Procedures

Additional codes that may be used in various physical therapy settings.

• 97760: Orthotic Management and Training
  Assessment and fitting of orthotic devices.
• 97761: Prosthetic Training
  Training for patients with new prosthetic devices.
• 97762: Checkout for Orthotic/Prosthetic Use
  Evaluation and fitting check for orthotic/prosthetic devices.
• 97032: Electrical Stimulation (Manual)
  Application of electrical stimulation for muscle and nerve stimulation.
• 97033: Iontophoresis
  Transdermal drug delivery using electrical current.
• 97034: Contrast Baths
  Alternating immersion in hot and cold water baths.
• 97035: Ultrasound Therapy
  Use of sound waves to treat musculoskeletal injuries.
• 97036: Hubbard Tank
  Use of a full-body immersion tank for therapy.

Important Considerations

• Billing in Time Units: Many physical therapy codes are billed in 15-minute increments. Make sure your documentation reflects the time spent on each procedure.
• Use of Modifiers: Consider using modifiers like 59 for distinct procedural services when necessary. This helps clarify billing when multiple services are provided in one session.
• Documentation: Ensure your documentation is thorough, as it is crucial for supporting the CPT codes used and for defending against audits or denials.

Conclusion

Having a clear understanding of CPT codes used in physical therapy is essential for accurate billing and optimal reimbursement. By using the appropriate codes and ensuring thorough documentation, physical therapists can improve their billing practices and support the financial health of their practices. At Certified Healthcare Billing, we specialize in physical therapy billing services, providing expert solutions to streamline your billing processes and maximize your practice’s revenue.

Contact us today to learn how we can support your practice’s billing needs.