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Business Practices/Administration Concerns

Reimbursement Coding

Therapists often use the following American Medical Association Current Procedural Terminology (CPT) codes when charging for services. Providers of rehabilitation therapy services must refer to their Local Medicare Review Policy (LMRP) and private insurance carriers regarding payment for services when using these codes. Therapists must also check whether these codes can be used for the specific ICD-9 diagnostic code(s) assigned to each patient/client when referred to therapy. See AMA Guide to CPT Coding for information on CPT coding and descriptions. To identify LMRPs for therapy services: cms.hhs.gov/mcd/search.asp

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Common CPT Codes Used in Therapy
(*are timed codes)
Code Service
93797 Cardiac rehab (incident to physician) without continuous ECG monitoring
93798 Cardiac rehab (incident to physician) with continuous ECG monitoring
94620 Simple exercise test (with or without oxygen monitoring)
94640 Demonstration and/or evaluation of pt/client utilization of an aerosol generator, nebulizer, metered dose inhaler, or IPPB device
94664 Demonstration and/or evaluation of pt/client utilization of an aerosol generator, nebulizer, metered dose inhaler, or IPPB device
94667 Manipulation of chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation
94668 Manipulation of chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent
97001 Physical therapy evaluation
97002 Physical therapy reevaluation
97005 Occupational therapy evaluation
97010 Hot or cold packs
97012 Traction, mechanical
97014 Electrical stimulation (unattended)
97016 Vasopneumatic services
97018 Paraffin bath
97020 Microwave
97022 Whirlpool
97024 Diathermy
97026 Infrared
97028 Ultraviolet
97032* Electrical stimulation (manual), 15 min
97033* Iontophoresis
97034* Contrast baths, 15 min
97035* Ultrasound, 15 min
97036* Hubbard tank, 15 min
97039 Unlisted modality
97110* Therapeutic exercise, 15 min
97112* Neuromuscular reeducation, 15 min
97113* Aquatic therapy with therapeutic exercise, 15 min
97116* Gait training, 15 min
97124* Massage, 15 min
97139 Unlisted physical medicine procedure
97140* Manual therapy techniques, 15 min
97150 Therapeutic procedures, group
97504* Orthotics fitting and training, 15 min
97520* Prosthetics training, 15 min
97530* Therapeutic activities, 15 min
97532* Development of cognitive skills, one-on-one, each 15 min
97533* Sensory integrative techniques, one-on-one, each 15 min
97535* Self-care and home management, 15 min
97537* Community/work reintegration, 15 min
97542* Wheelchair management/propulsion training, 15 min
97545 Work hardening/conditioning, initial 2 h
97546 Work hardening/conditioning, each additional h
97597 Removal of devitalized tissue from wound, selective débridement w/o anesthesia, less than or equal to 20 sq cm
97598 Débridement of total wound surface area >20 sq cm
97602 Non-selective débridement
97605 Negative pressure wound therapy; total wound surface area < or equal to 50 sq cm
97606 Negative pressure wound therapy, total wound surface area >50 sq cm
97703* Checkout for orthotic/prosthetic use, estab pt/client, each 15 min
97750* Physical performance test or measurement, each 15 min (report required to accompany claim)
97755 Assistive technology assessment
G0422 Intensive cardiac rehab services w/exercise
G0423 Intensive cardiac rehab services w/o exercise
G0424 Pulmonary rehab services* (only used with ...

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