Is there a CPT code for physical therapy?

Yes, there are CPT codes for physical therapy, including:

- 97110: Therapeutic exercises

- 97140: Manual therapy techniques

- 97161, 97162, 97163: Physical therapy evaluation (low, moderate, and high complexity)

- 97164: Physical therapy re-evaluation

- 97165, 97166, 97167: Occupational therapy evaluation (low, moderate, and high complexity)

- 97168: Occupational therapy re-evaluation

- 97530: Therapeutic activity

- 97542: Wheelchair management

- 97010: Hot or cold packs application

- 97012: Mechanical traction

- 97014: Electrical stimulation (unattended)

- 97016: Vasopneumatic device

- 97018: Paraffin bath

- 97022: Whirlpool

- 97024: Diathermy

- 97026: Infrared

- 97028: Ultraviolet

- 97032: Electrical stimulation (manual)

- 97033: Iontophoresis

- 97034: Contrast bath

- 97035: Ultrasound

- 97036: Hubbard tank

What are the most common physical therapy CPT codes?

Here are some of the most common physical therapy CPT codes:

1. 97110:  Therapeutic exercises (e.g., strengthening, range of motion, flexibility)

2. 97140:  Manual therapy techniques (e.g., massage, joint mobilization, soft tissue mobilization)

3. 97530:  Therapeutic activity (e.g., balance, coordination, functional training)

4. 97161:  Physical therapy evaluation (low complexity)

5. 97162:  Physical therapy evaluation (moderate complexity)

6. 97163:  Physical therapy evaluation (high complexity)

7. 97164:  Physical therapy re-evaluation

8. 97014:  Electrical stimulation (unattended)

9. 97035:  Ultrasound

10. 97124:  Massage therapy

Keep in mind that CPT codes are subject to change, and it's essential to verify the codes with the American Medical Association (AMA) or your local Medicare Administrative Contractor (MAC) for the most up-to-date information.

How do physical therapy CPT codes work?

Physical therapy CPT (Current Procedural Terminology) codes are used to bill for physical therapy services. Here's how they work:

1. CPT code selection: Physical therapists choose the appropriate CPT code(s) based on the services provided during a treatment session.

2. Code categories: CPT codes are divided into three categories:

    - Evaluation codes (97161-97164): Used for initial evaluations and re-evaluations.

    - Intervention codes (97110-97546): Used for treatment interventions, such as exercises, manual therapy, and modalities.

    - Modalities codes (97010-97036): Used for physical agents, such as heat, cold, electrical stimulation, and ultrasound.

3. Code levels: Some codes have levels (e.g., 97110, 97112, 97113) that indicate the complexity or duration of the service.

4. Units: Physical therapists bill for services in units (e.g., 15-minute increments).

5. Modifiers: Modifiers (-59, -76, -77) may be added to codes to indicate specific circumstances (e.g., separate sessions, repeat treatments).

6. Billing: The physical therapist submits the CPT code, units, and modifiers to the payer (insurance company) for reimbursement.

7. Reimbursement: The payer reimburses the physical therapist based on the CPT code, units, and modifiers.

It's important to note that CPT codes are subject to change, and physical therapists must stay up-to-date with the latest codes and guidelines to ensure accurate billing and reimbursement.

Beginner's guide to physical therapy coding cheat sheet 

Here is a physical therapy coding cheat sheet:

*Evaluation Codes*

- 97161: PT Evaluation (Low Complexity)

- 97162: PT Evaluation (Moderate Complexity)

- 97163: PT Evaluation (High Complexity)

- 97164: PT Re-Evaluation

*Intervention Codes*

- 97110: Therapeutic Exercises

- 97112: Therapeutic Exercises (Moderate Complexity)

- 97113: Therapeutic Exercises (High Complexity)

- 97140: Manual Therapy Techniques

- 97530: Therapeutic Activity

*Modalities Codes*

- 97010: Hot or Cold Packs

- 97012: Mechanical Traction

- 97014: Electrical Stimulation (Unattended)

- 97016: Vasopneumatic Device

- 97018: Paraffin Bath

- 97022: Whirlpool

- 97024: Diathermy

- 97026: Infrared

- 97028: Ultraviolet

- 97032: Electrical Stimulation (Manual)

- 97033: Iontophoresis

- 97034: Contrast Bath

- 97035: Ultrasound

*Modifiers*

- -59: Distinct Procedural Service

- -76: Repeat Procedure or Service

- -77: Repeat Procedure or Service (Same Day)

*Units*

- 15-minute increments (e.g., 1 unit = 15 minutes)

Remember to always verify the codes and guidelines with your local Medicare Administrative Contractor (MAC) or private payers, as they may have specific requirements.

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