Effective
January 1, 2017, several occupational therapy (OT) and physical therapy (PT)
evaluation and re-evaluation CPT codes have been replaced by new codes. EI
Billing Providers should become familiar with these new codes, and begin using
them when appropriate.
New OT Evaluation and
Re-evaluation CPT Codes
The final CMS
physician fee schedule for 2017 introduced three new CPT codes for occupational
therapy evaluation and one new code for reevaluation. The new evaluation codes
reflect 3 levels: low-complexity (97165), moderate-complexity (97166), and
high-complexity (97167), and replace the current 97003 code. The new
reevaluation code (97168) replaces the current 97004.
For descriptors
of each of these new codes, please follow this link.
For additional
resources on these new OT CPT codes, please follow this link to the American Physical Therapy
Association (APTA) website.
New PT Evaluation and
Re-evaluation CPT Codes
The final CMS
physician fee schedule for 2017 introduced three new CPT codes for physical
therapy evaluation and one new code for reevaluation. The new evaluation codes
reflect 3 levels of patient presentation: low-complexity (97161),
moderate-complexity (97162), and high-complexity (97163), and replace the
current 97001 code. The new reevaluation code (97164) replaces the current
97002.
For a reference
table on the new codes, please follow this link.
For additional
resources on these new PT CPT codes, please follow this link to the American Occupational Therapy
Association (AOTA) website.
If
you have any questions, please contact the PCG Customer Service Call Center at
(866) 315-3747.