Timely payments are key to running a successful practice since clinics need consistent revenue to operate. Insurance companies can process your claims quickly if you practice proper physical therapy billing. You can use physical therapy codes to reduce the risk of improper or unnecessary billing.
What Are Physical Therapy Codes?
Physical therapy codes are numerical codes used by qualified physical therapists to report services rendered and procedures performed on a patient. They’re integral to medical billing as they describe the care you give to your patients, making it easier for insurance companies to process claims. Physical therapy codes should match the kind of service rendered for seamless communication between your clinic and patients’ insurers.
Common Codes
Understanding physical therapy codes can help you receive fair compensation for your services. Here are some codes every physical therapist should know:
97110: Therapeutic Exercise
This code represents exercises meant to build patient strength and endurance and increase their range of motion. You should have direct contact with your patient to bill for this service.
Some physical therapists confuse physical exercise with physical activity — while both appear to be almost similar, they’re billed differently since insurance companies perceive them to require different levels of skills. Insurers believe physical therapists can guide patients’ therapeutic exercises without being hands-on — they compensate less for therapeutic exercises than activities. Therapeutic exercises include walking on a treadmill, stretching, and riding a stationary bike.
97112: Neuromuscular Re-education
This code identifies exercises that help restore patients’ body aspects like coordination, posture, and kinesthetic sense. You can classify any activity that involves re-training body muscles to function in a specific way under this code. Common examples of neuromuscular re-education exercises include muscle desensitization exercises, plyometrics, and ergonomic training.
97116: Gait Training
This code represents exercises meant to help patients stand and walk comfortably. They aim to strengthen the muscles in patients’ legs, build walking and standing endurance, and improve balance. Physical therapists help patients achieve these goals using repetitive motions, often using machines like ellipticals that help them support their weights. Gait training is helpful for patients with broken legs, brain injuries, strokes, and spinal cord injuries.
97140: Manual Therapy
Manual therapy includes exercises with direct patient contact meant to reduce joint contracture, increase soft tissue or joint mobilization and increase muscle energy. Most exercises that involve applying pressure and resistance to patients’ muscles can fall under this category.
97150: Group Therapy
This code represents all physical therapy exercises involving more than one patient. You should categorize any activity that doesn’t involve giving every patient one-on-one time under this code. Some insurers require additional information on the number of participants you have in each group, and the kind of activities you partake in, so be sure to clarify such details.
97530: Therapeutic Activities
This code represents activities that improve patients’ functional performance. Such activities include practicing getting in and out of a vehicle, squatting, swinging a bat, bed mobility, and going up and down the stairs. These activities require skilled physical therapists to prevent injuries, so they’re billed at a higher rate than therapeutic exercises.
97535: Home Management Training
Home management training involves activities aimed at helping patients live independently. They include activities of daily living (ADL) training and assistive device training. ADL training can improve patients’ flexibility and endurance, allowing them to partake in basic activities like dressing, eating, and bathing. You can offer home management training to patients who’ve just had surgery.
97750: Physical Performance Measurement
This code represents tests you can conduct to understand the severity of a patient’s situation. The tests include grip tests, sensory tests, gait analysis, and pinch tests — they help determine the kind of services the patient needs.
97761: Prosthetic Training
This code represents activities that involve training patients with prosthetic limbs on how to walk, sit, run, hold objects, write, or wave. It also covers assessments for prosthetics and fittings.
97762: Prosthetic Use
This code represents prosthetic limb evaluations. Physical therapists can bill tests meant to measure the effectiveness of patients’ prosthetic limbs under this code. You can also seek compensation for adjusting the limbs through this code.
Codes Can Help You With Physical Therapy Billing
You may be able to improve the chances of fast insurance claim compensation by billing your services correctly — physical therapy codes can help you with this. These codes help with coherent communication between insurance companies and physical therapists. They represent exercises and activities in a language both parties can understand, helping to make physical therapy billing easier. Take time to understand these codes for more efficient billing and consider utilizing a professional physical therapy billing service to streamline your billing process.
