Physical therapy plays a crucial role in helping patients regain mobility, strength, and overall function after injuries, surgeries, or chronic conditions. Billing for these services requires the correct use of CPT (Current Procedural Terminology) codes to ensure proper reimbursement.
Among the most commonly used codes in physical therapy is CPT code 97110, which covers therapeutic exercises. This article explores what 97110 entails, its applications, and its significance in physical therapy treatment plans.
What is CPT Code 97110?
CPT code 97110 refers to therapeutic exercises performed to develop strength, endurance, range of motion, and flexibility. These exercises are designed to help patients improve or restore their physical function and are a key component of rehabilitation programs.
This code is used when a licensed physical therapist provides one-on-one, direct supervision while the patient performs prescribed exercises. The billing is typically done in 15-minute increments, meaning that multiple units can be billed if the session extends beyond a single 15-minute block.
How is CPT 97110 Used?
Physical therapists utilize CPT code 97110 in individualized treatment plans tailored to the patient’s needs. Approximately 300 million physical therapy visits occur annually in the United States and therapeutic exercises are among the most common treatments used to restore function. The exercises may involve:
- Strength training – Resistance exercises to improve muscle strength.
- Range of motion (ROM) exercises – Stretching and movement techniques to improve joint mobility.
- Endurance training – Activities that enhance cardiovascular and muscular endurance.
- Flexibility exercises – Stretching routines to prevent stiffness and improve movement.
Each exercise is performed under the therapist’s direct supervision, ensuring the correct technique and progress tracking.
When is CPT 97110 Used?
CPT code 97110 is used in post-surgical rehabilitation to restore strength and mobility after procedures like knee replacement or rotator cuff surgery. It also helps patients recover from musculoskeletal injuries, such as fractures, sprains, and tendonitis. In neurological conditions like stroke or multiple sclerosis, these exercises improve coordination and muscle control.
For chronic pain management, including arthritis and fibromyalgia, they help reduce stiffness and enhance movement. Additionally, CPT 97110 supports postural and gait correction to prevent strain and improve mobility. Proper documentation of medical necessity, treatment goals, and progress is essential for successful reimbursement.
Billing and Documentation Considerations
To avoid claim denials, physical therapists must maintain thorough documentation of the exercises performed, including the specific purpose of each exercise. It is important to accurately specify the time spent on each session, as this helps justify the number of units billed, typically in 15-minute increments.
Furthermore, therapists should demonstrate the medical necessity of the exercises by linking them directly to the patient’s diagnosis and treatment goals. This documentation should clearly reflect the need for the prescribed exercises and show how they contribute to the patient’s progress, ensuring compliance with insurance requirements and smooth reimbursement processes.
Conclusion
CPT code 97110 is a fundamental code in physical therapy, representing a broad range of therapeutic exercises that help improve a patient’s functional abilities. Proper documentation and coding practices are crucial to ensure smooth reimbursement and provide effective patient care. By understanding when and how to use 97110, physical therapists can maximize treatment outcomes while remaining compliant with billing regulations.
We specialize in physical therapy billing services, ensuring that your practice navigates the complexities of billing codes like CPT 97110 with ease. Our expert team can help you optimize your billing processes, reduce claim denials, and ensure timely reimbursement, allowing you to focus on delivering high-quality care to your patients.
With a strong background in the marketing industry and healthcare leadership roles, Filip is responsible for CLICKVISIONBPO’s sales strategies and onboarding new clients. With a passion for sharing insights gained from his experience, he also shares valuable knowledge through industry related articles.