Knowledge of the common physical therapy CPT codes is required to ensure quick reimbursements from insurance companies. A huge part of the income of a physical therapy clinic is derived from insurance companies. Getting reimbursed quickly and without any denials should be the number one goal for any medical facility. This will help in the cash flow and liquidity of the business.
A business owner can always use a billing software with integrated physical therapy CPT codes. This will allow for quick billing processes. Although this might be the case, a good check and balance system like reviewing to make sure the appropriate physical therapy CPT codes are used before the billing is sent out, is a good operating procedure to follow.
Some newly opened clinics might not have the resources to buy expensive billing software yet so knowledge is really important. Having reading materials and resources for quick reference handy is best in case the billing staff needs to verify the correct physical therapy CPT codes to use.
The most commonly used physical therapy CPT codes are listed below:
For initial evaluation, CPT code 97001 is used. This is when a physical therapist assesses and documents the patient’s medical history, any diagnosis and prognosis. Re-evaluations can also be billed under CPT 97002. If tests and any measurements are required as part of evaluations and/or re-evaluations, CPT codes 97750 – 97755 should be used.
For modalities applied to the patient, physical therapy CPT codes 97032-97039 are used. These treatment procedures require constant attendance and/or supervision of the physical therapist. These modalities can also be categorized as timed or not-timed. Modalities normally include services like ultrasound, electric stimulation and ionthophoresis.
Physical therapy CPT codes 97110 – 97546 are used for therapeutic procedures. These procedures are timed and require one-on-one and direct patient contact. Activities under this group include aquatic therapy, manual therapy and gait training.
For the management and treatment of active wounds, physical therapy CPT codes 97597 – 97606 are used. These wound care treatment aims to promote healing through the removal of necrotic and devitalized tissues from the body. Direct contact is also required.
Physical therapy CPT codes 97760 – 97762 are for prosthetic and orthotic management. Physical therapists who offer specialized training and education for patients with prosthetics and orthotics can use these codes.
Different insurance companies have varying billing documentation requirement aside from using the correct physical therapy CPT codes. It is a must for a physical therapy business to be always updated to any changes in billing procedures to ensure quick reimbursement and no claims denial.