Physical and Occupational Therapy and Chiropractic modalities
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| CPT Code | Description |
|---|---|
| 97012 | Application of a modality to 1 or more areas; traction, mechanical |
| 97014 | Application of a modality to 1 or more areas; electrical stimulation (unattended |
| 97016 | Application of a modality to 1 or more areas; vasopneumatic devices |
| 97018 | Application of a modality to 1 or more areas; paraffin bath |
| 97022 | Application of a modality to 1 or more areas; whirlpool |
| 97024 | Application of a modality to 1 or more areas; diathermy (e.g., microwave) |
| 97032 | Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes |
| 97034 | Application of a modality to 1 or more areas ; contrast baths, each 15 minutes |
| 97035 | Application of a modality to 1 or more areas; ultrasound, each 15 minutes |
| 97036 | Hubbard tank, each 15 minutes |
| 97039 | Unlisted modality (specify type and time if constant attendance) |
| 97110 | Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility |
| 97112 | Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities |
| 97113 | Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises |
| 97116 | Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing) |
| 97124 | Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion) |
| 97139 | Unlisted therapeutic procedure (specify) |
| 97140 | Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes |
| 97161 | Physical therapy evaluation; low complexity, requiring these components:A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patientand/or family |
| 97162 | Physical therapy evaluation; moderate complexity, requiring these components:A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized test and measure in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions;An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 30 minutes are spentface-to-face with the patient and/or family |
| 97163 |
|
| 97164 |
Re-evaluation of physical therapy established plan of care, requiring these components:
Typically, 20 minutes are spent face-to-face with patient and/or family |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact by the provider (use ofdynamic activities to improve functional performance), each 15 minutes |
| 97535 | Self-care/home management techniques to enhance sensory processing and promoteadaptive responses to environmental demands, direct (one-on-one) patient contact by the provider, each 15 minutes |
| 97542 | Wheelchair management (e.g., assessment, fitting, training), each 15 minutes |
| 97550 | Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; initial 30 minutes |
| 97551 | Caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face; each additional 15 minutes (List separately in addition to code for primary service) |
| 97552 | Group caregiver training in strategies and techniques to facilitate the patient’s functional performance in the home or community (eg, activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face with multiple sets of caregivers |
| 97760 | Orthotic(s) management and training (including assessment and fitting when nototherwise reported), upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes |
| 97761 | Prosthetic training, upper and/or lower extremity(s), each 15 minutes |
| 97763 | Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lowerextremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes |
| 97799 | Unlisted physical medicine/rehabilitation service or procedure |
| HCPCS Codes | Description |
|---|---|
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other thanwound care, as part of a therapy plan of care |
| S8950 | Complex lymphedema therapy, each 15 minutes |
Occupational Therapy Applicable Codes:
| CPT Code | Description |
|---|---|
| 96112 | Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardizeddevelopmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour |
| 96113 | Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; each additional 30 minutes (List separately in addition to code for primary procedure) |
| 97012 | Application of a modality to 1 or more areas; traction, mechanical |
| 97014 | Application of a modality to 1 or more areas; electrical stimulation (unattended) |
| 97016 | Application of a modality to 1 or more areas; vasopneumatic devices |
| 97018 | Application of a modality to 1 or more areas; paraffin bath |
| 97022 | Application of a modality to 1 or more areas; whirlpool |
| 97024 | Application of a modality to 1 or more areas; diathermy (e.g., microwave) |
| 97032 | Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes |
| 97034 | Application of a modality to 1 or more areas; contrast baths, each 15 minutes |
| 97035 | Application of a modality to 1 or more areas; ultrasound, each 15 minutes |
| 97036 | Application of a modality to 1 or more areas; Hubbard tank, each 15 minutes |
| 97039 | Unlisted modality (specify type and time if constant attendance) |
| 97110 | Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises todevelop strength and endurance, range of motion and flexibility |
| 97112 | Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducationof movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities |
| 97113 | Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy withtherapeutic exercises |
| 97116 | Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stairclimbing) |
| 97124 | Therapeutic procedure, 1 or more areas, each 15 minutes; massage, includingeffleurage, petrissage and/or tapotement (stroking, compression, percussion) |
| 97139 | Unlisted therapeutic procedure (specify) |
| 97140 | Manual therapy techniques (e.g., mobilization/manipulation, manual lymphaticdrainage, manual traction), one or more regions, each 15 minutes |
| 97165 | Occupational therapy evaluation: low complexity, requiring these components:An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; An assessment(s) that identifies 1-3 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of low complexity, which includes an analysis of the occupational profile, analysis of data from problem- focused assessment(s), and consideration of a limited number of treatment options. Patient presents with no comorbidities that affect occupational performance.Modification of tasks or assistance (eg, physical or verbal) with assessment(s) is not necessary to enable completion of evaluation componentTypically, 30 minutes are spent face-to-face with the patient and/or family |
| 97166 | Occupational therapy evaluation: moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 3-5 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of moderate analytic complexity, which includes an analysis of the occupational profile, analysis of data from detailed assessment(s), and consideration of several treatment options. Patient may present with comorbidities that affect occupational performance. Minimal to moderate modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation componentTypically, 45 minutes are spent face-to-face with the patient and/or family |
| 97167 | Occupational therapy evaluation: high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 5 or more performance deficits (i.e., relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of high analytic complexity, which includes an analysis of the patient profile, analysis of data from comprehensive assessment(s), and consideration of multiple treatment options. Patient presents with comorbidities that affect occupational performance. Significant modification of tasks or assistance (e.g., physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation componentTypically, 60 minutes are spent face-to-face with the patient and/or family |
| 97168 | Re-evaluation of occupational therapy established plan of care, requiring thesecomponents: An assessment of changes in patient functional or medical status with revised plan of care; An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and A revised plan of care. A formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is requiredTypically, 30 minutes are spent face-to-face with the patient and/or family |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact by the provider (use ofdynamic activities to improve functional performance), each 15 minutes |
| 97535 | Self-care/home management training (e.g., activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use ofassistive technology devices/adaptive equipment), direct (one-on-one) patient contact, each 15 minutes |
| 97542 | Wheelchair management (e.g., assessment, fitting, training), each 15 minutes |
| 97760 | Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initialorthotic(s) encounter, each 15 minutes |
| 97761 | Prosthetic(s) training, upper and/or lower extremity(s), initial prosthetic(s) encounter,each 15 minutes |
| 97763 | Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lowerextremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes |
| 97799 | Unlisted physical medicine/rehabilitation service or procedure |
| HCPCS Code | Description |
|---|---|
| G0283 | Electrical stimulation, (unattended), to one or more areas for indication(s) other thanwound care, as part of a therapy plan of care |
| S8950 | Complex lymphedema therapy, each 15 minutes |
Chiropractic Applicable Codes:
| CPT Code | Description |
|---|---|
| 97012 | Application of a modality to 1 or more areas; traction, mechanical |
| 97014 | Application of a modality to 1 or more areas; electrical stimulation(unattended) |
| 97016 | Application of a modality to 1 or more areas; vasopneumatic devices |
| 97022 | Application of a modality to 1 or more areas; whirlpool |
| 97024 | Application of a modality to 1 or more areas; diathermy (e.g., microwave) |
| 97032 | Application of a modality to 1 or more areas; electrical stimulation (manual),each 15 minutes |
| 97035 | Application of a modality to 1 or more areas; ultrasound, each 15 minutes |
| 97110 | Therapeutic procedure, 1 or more areas, each 15 minutes; therapeuticexercises to develop strength and endurance, range of motion and flexibility |
| 97112 | Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscularreeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities |
| 97140 | Manual therapy techniques (e.g., mobilization/manipulation, manuallymphatic drainage, manual traction), 1 or more regions, each 15 minutes |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact (use of dynamicactivities to improve functional performance), each 15 minutes |
| 97535 | Self-care/home management training (e.g., activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment), direct one-on-onecontact , each 15 minutes |
| 97799 | Unlisted physical medicine/rehabilitation service or procedure |
| 98940 | Chiropractic manipulative treatment (CMT); spinal, one or two regions |
| 98941 | Chiropractic manipulative treatment (CMT); spinal, three to four regions |
| 98942 | Chiropractic manipulative treatment (CMT); spinal, five regions |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for codeselection, 15-29 minutes of total time is spent on the date of the encounter. |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection,30-44 minutes of total time is spent on the date of the encounter. |
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for codeselection, 45-59 minutes of total time is spent on the date of the encounter. |
| 99205 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection,60-74 minutes of total time is spent on the date of the encounter. |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) areminimal. |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 10-19 minutes of total time is spent on the date of theencounter. |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20-29 minutes of total time is spent on the date of theencounter. |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30-39 minutes of total time is spent on the date of theencounter. |
| 99215 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of theencounter. |
| HCPCS Code | Description |
|---|---|
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s)other than wound care, as part of a therapy plan of care |
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform.
|