Log in

Physical Therapy CPT Codes: A Quick Guide for Therapists

Updated on
June 21, 2023
Physical Therapy Business Tips
physical therapy CPT codes

Physical therapy CPT codes and the world of insurance is confusing unless you majored in medical billing. If you're opening a physical therapy business, you need to know about these things. Using the right codes is the difference between earning a living and not getting paid. This simple guide gives you an overview of common CPT codes for PTs and when to use them.

What Are Physical Therapy CPT Codes?

Current Procedural Terminology (CPT) codes are used to report medical treatment, including physical therapy, to insurance providers. Their purpose is to streamline claim processing. The American Medical Association manages and develops these CPT codes and uses them to create guidelines for care review. 

When you start a physical therapy business, you need to decide how you'll get paid. Will you bill patients directly or bill their insurance? 

Opting to be an In-Network Provider requires entering into contracts with insurance companies. Treatment is typically billed in 15 minute increments. When you bill insurance, you use physical therapy CPT codes to report the details of the treatment provided. Then, the insurance provider reviews the codes to determine what qualifies for reimbursement.

Now, let's move on to the most common physical therapy CPT codes.

Here's A List Of CPT Codes for PTs

97110:  Therapeutic Exercise

97140:  Manual Therapy

97112:  Neuromuscular Re-Education

97530:  Therapeutic Activities

97150:  Group Therapy

97750:  Physical Performance Test or Measurement

97116:  Gait Training

97535:  Self-Care/Home Management Training

97761:  Prosthetic Training

97161:  PT Evaluation: Low Complexity

97162:   PT Evaluation: Moderate Complexity

97163:   PT Evaluation: High Complexity

97014:   Electrical Stimulation (Unattended)

97032:   Electrical Stimulation (Manual)

97124:  Massage Therapy

CPT Codes for PT's

97110:  Therapeutic Exercise

Therapeutic exercise is any movement that's designed to improve ROM, strength, or flexibility after a surgery or injury. Include specifics about what muscles or joints were involved in the exercises.

Examples of Therapeutic Exercise include:

  • Active stretching
  • Active, active-assisted, or passive ROM of a joint
  • Treadmill or Bicycle
  • Resistance exercises

97140:  Manual Therapy

Manual therapy is used to decrease muscle contracture and restore mobility of joints and soft tissue. Hands-on therapies like manual traction, manual lymph drainage, passive range of motion, soft tissue and joint mobilization are considered manual therapy. This is not the same thing as massage therapy. 

97112:  Neuromuscular Re-Education

Neuromuscular Re-Education is used to retrain the brain. Exercises that improve the brain's ability to control balance, movement, posture, and proprioception fall under this CPT code.

Neuromuscular Re-Education includes things like:

  • Ergonomic training
  • Kinesiotaping
  • Stabilization exercises

97530:  Therapeutic Activities

Therapeutic activities use dynamic movements to improve functional performance. Dynamic exercises use the strength, stability, and flexibility needed for daily activities. The intention behind the exercise determines whether it's a therapeutic activity or a therapeutic exercise. If the purpose is to improve function, not just strength of flexibility, it's a therapeutic activity.

Consider the following when determining if an exercise is a therapeutic activity:

  • Does it use more than one parameter (i.e. strength + balance)?
  • Does the movement relate directly to a sport or activity they do in daily life?
  • Is it a functional activity, like climbing stairs?

97150:  Group Therapy

Group therapy is when the patient performs exercises with a group, instead of one-on-one with the PT. Patients don't necessarily have to do the same exercises as others in the group for treatment to be considered group therapy. A group is  2 or more patients that the physical therapist is supervising at the same time.

97750:  Physical Performance Test or Measurement

Physical Performances Tests or Measurements are required to assess a patient before designing a treatment strategy.

These assessments include:

  • Sports-related tests
  • Functional assessments
  • Sensory tests
  • Strength tests
  • Gait analysis

97116:  Gait Training

Use the gait training code when treatment includes exercises intended to improve the patient's ability to walk and decrease their risk of falling. This includes exercises focused on strengthening the legs, and improving balance and posture.

Examples of Gait Training:

  • Elliptical
  • Treadmill
  • Strength training machines
  • Leg lifts
  • Stepping over objects
  • Getting up and down from a chair or the floor

97535:  Self-Care/Home Management Training

This is a treatment designed to help an injured or disabled patient be able to live independently. This includes exercises that improve their ability to: get in/out of bed or a wheelchair, get dressed, bathe, and other essential activities of daily living.

97761:  Prosthetic Training

Prosthetic training is when you work with a patient with a new prosthetic limb. Use this code for assessment, fitting the patient for a prosthetic, and teaching them how to take it on and off. Prosthetic training is also used to help patients learn to use their new prosthetic for things like standing, walking, waving, holding an object, etc.

97161, 97162, 97163:  PT Evaluation

There are 3 tiers of physical therapy evaluation. The American Physical Therapy Association explains the tiers are determined by the following:

  • Medical  history
  • Number of body systems/structures/functions involved
  • Clinical presentation
  • The complexity of clinical decision making.  

PT Evaluation Code

Here's a breakdown of which code to use when billing for a PT Evaluation:

97161: PT Evaluation: Low Complexity

  • No personal factors and/or comorbidities
  • Addressing 1-2 elements
  • Presentation is stable
  • The complexity of clinical decision making is low

97162: PT Evaluation: Moderate Complexity

  • 1-2 personal factors and/or comorbidities
  • Addressing 3+ elements
  • Presentation is evolving
  • Complexity of clinical decision-making in moderate

97163: PT Evaluation: High Complexity

  • 3+ personal factors and/or comorbidities
  • Addressing 4+ elements
  • Presentation is unstable
  • The complexity of clinical decision-making is high

97014, G0283 for Medicare, 97032 :  Electrical Stimulation 

How you code electrical stimulation is determined by how you apply the modality.

97014 or G0283 for Medicare: Electrical Stimulation (Unattended)

If you simply place the electrodes on the patient, set the parameters, turn on the machine, and then remove the electrodes afterwards, this is considered unattended.

97032:   Electrical Stimulation (Manual)

If electrical stimulation is applied in conjunction with having the patient perform a movement, this is considered manual. An example of this is performing muscle contractions, ROM, or gait training while electrical stimulation is being applied.

97124:  Massage Therapy

The massage therapy CPT code is different from the manual therapy CPT code because the techniques are different. Manually treating muscles using the following techniques is considered massage therapy:  effleurage, petrissage and/or tapotement.

What If I'm An Out-Of-Network Provider Or Cash-Based Clinic?

If your physical therapy business is a cash-based clinic, meaning you're an Out-Of-Network provider for all patients, the need for coding diminishes. The main purpose of CPT codes is to streamline claim processing. If you're not submitting claims to insurance providers, coding is less essential.

Out-Of-Network providers bill patients directly. It's up to the patient to request reimbursement from their insurance provider. You can add CPT codes to treatment details when you invoice patients directly. This gives patients something to submit to their insurance for reimbursement.

Accounting and documenting with SOAP notes is easier when you use practice management software like ClinicSense. You can automate most of your administrative tasks, like invoicing patients. That frees you up to spend time doing other things, like learning physical therapy CPT codes.

physical therapy software sign up
download no show preventionDOWNLOAD

Table of contents

Explore by topic

Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Relevant Articles

Relevant Articles

How To Start a Physical Therapy Business: A 15 Step Guide

How To Start a Physical Therapy Business: A 15 Step Guide

Physical Therapy Business Tips
Updated on
January 3, 2024
Massage Therapy Insurance: What You Need to Know

Massage Therapy Insurance: What You Need to Know

Massage Therapy Tips
Updated on
October 25, 2023

Ready to get started?

Start Free Trial