APTA Coding and Billing Information
International Classifications of Diseases 10th Revision, Clinical Modification (ICD-10-CM)
- APTA ICD-10 (ICD-10-CM)
- Outpatient PT-First Visit for CVA
- Outpatient PT-First Visit for Multiple Sclerosis
- Outpatient PT-First Visit for Parkinson Disease
- Centers for Disease Control and Prevention
- Free Reference Website ICD10data.com
Tiered Physical Therapy Evaluation Codes
The final CMS physician fee schedule for 2017 introduced the 3 new CPT codes for physical therapy evaluation and 1 new code for reevaluation. The new evaluation codes reflect 3 levels of patient presentation: low-complexity (97161), moderate-complexity (97162), and high-complexity (97163), and replace the current 97001 code. The new reevaluation code (97164) replaces the current 97002.
Common Procedural Codes (CPT)
Common PT Codes for Neuro Populations
- 97110: Therapeutic Exercise
- 97112: Neuromuscular Re-education
- 97116: Gait Training
- 97140: Manual Therapy
- 97150: Group Therapy (Group resource link)
- 97530: Therapeutic Activities
- 97452: Wheelchair Management
- 97537: Community/Work Reintegration
- 97750: Physical Performance Test
- 97760, 97763: Orthotic Management/Training
- 97533 Sensory Integration
- 90901, 90911: Biofeedback
- 97032: Electrical Stimulation
8-Minute Rule
Medicare Coverage of Skilled Maintenance
KX Modifier Code
CQ Modifier Code
Medicare Post-acute Care Reform and Value Based Payment Models
- Private Practice Medicare Payment Thresholds for Outpatient Therapy Services
- Quality Payment Program (QPP) Certain PTs in private practice will be required to participate in the QPP program through either
- Alternative Payment Models Merit-based Incentive Payment System (MIPS)
- Advanced Alternative Payment Models (APMs)
- Skilled Nursing Facility (PDPM) and Home Health Payment Models (PDGM) Skilled Nursing Facility - Patient-Driven Payment Model (PDPM)
- Home Health - Patient-Driven Groupings Model (PDGM)
- Busting Medicare Part B Myths (and Regulating Your Expectations) Part I
- Concussion management
- Durable Medical Equipment, Prosthetic, Orthotic & Supplies (DMEPOS)
- Electromyography (EMG)
- Fair Physical Therapy CoPays Advocacy
- Orthotics, Prosthetics, Casting, Strapping, and Taping
- Referral for Profit
- Safe Pain Management Advocacy
- Telehealth: Billing and Coding Considerations