10 Common CPT Codes a Physical Therapist Can Bill

Quality physical therapy billing services can help you receive consistent revenue to keep your practice operating.

Physical therapy billing involves various key processes, one of the most fundamental being converting physical therapy services into CPT codes.

CPT codes allow physical therapy practices to communicate seamlessly with insurers, reducing the risk of billing errors. Here are ten common CPT codes:

1. 97750: Physical Performance Measurement

Code 97750 represents tests you can conduct to determine the seriousness of patients’ conditions. The tests typically come before treatments, as they determine the most effective exercises for patients. They include grip tests, gait analysis, pinch tests, and functional performance tests.

2. 97110: Therapeutic Exercise

This code represents physical therapy exercises meant to boost endurance and strength in any body part. It also represents any exercise that improves a patient’s flexibility and range of motion. Common exercises billed under this code include ballistic, isokinetic, and isotonic. You should have direct contact with your patient to use this code.

3. 97112: Neuromuscular Re-education

This code represents activities that aim to help patients regain normal body functioning. Any exercise that can help re-educate the brain on how to control various body muscles falls in this category. Neuromuscular re-education can help patients with their balance, kinesthetic senses, and postures. Under this code, you can bill activities like muscle desensitization, Kinesio Taping, and ergonomic training.

4. 97116: Gait Training

The code represents exercises aiming to strengthen patients’ leg muscles and joints. These exercises are often performed with the help of assistive devices like ellipticals to help with balance and build endurance. You can also bill activities like having patients jump over items using this code if their purpose is to help them walk with minimal fall risk.

5. 97140: Manual Therapy

Any activity involving pressure and resistance to patients’ muscles can be billed under this code. Examples include manual traction, soft tissue mobilization, and lymphatic drainage. These activities are reimbursed at a lower rate than other physical therapy services as they fall more under massage therapy than physical therapy. But they’re a great addition to a physical therapy program containing other exercises.

6. 97150: Group Therapy

This code represents any service offered in a group setting, so you can use it anytime you serve multiple patients at once. The code has a competitive reimbursement, as the activities, it represents require constant supervision. But, you may get a lower reimbursement rate when compared to activities requiring one-on-one contact with patients. You should provide details on the number of patients in the group therapy when you use this code.

7. 97530: Therapeutic Activities

Code 97530 represents dynamic activities aiming to improve functional performance. Dynamic activities are exercises that require balance, strength, and flexibility. Undertaking these activities repeatedly can boost patients’ muscle memory, allowing them to move safely outside therapy. Activities represented by this code include stair negotiation exercises, bed mobility training, and sit-to-stand exercises.

You should be careful not to confuse therapeutic activities with therapeutic exercises when billing, as you may lose out on some money. Insurance companies reimburse therapeutic activities at a higher rate, as they believe they need a greater skill level than therapeutic exercises.

8. 97535: Home Management Training

This code represents activities meant to improve patients’ ability to live independently following accidents that prevent normal mobility. Sessions covered may involve teaching patients how to use assistive walking devices and activities of daily living (ADL) training. ADL training encompasses activities meant to strengthen muscles enough for patients to efficiently perform basic tasks like eating, bathing, dressing, and toileting.

9. 97761: Prosthetic Training

This code represents assessments for prosthetics, prosthetics fitting, and prosthetics training. You can bill time spent teaching patients how to wear and remove their prosthetic limbs and how to walk, sit, write, or grip.

10. 97762: Prosthetic Use

This code covers the time spent assessing the effectiveness of existing prosthetics. Assessment may be necessary if a patient complains about pain or loss of function because of their device. In this case, you can recommend device modifications or ask for a complete device change.

Physical Therapy Billing Services Can Help You With CPT Codes

CPT codes are integral to physical therapy billing, as they facilitate easy communication between medical professionals and insurers. Keeping track of all the codes while simultaneously focusing on your client’s needs can be challenging, hence the need for physical therapy billing services. These services can process, submit, and follow up on insurance claims per the current billing regulations, allowing you to focus on your patients and enjoy timely payments.