CATEGORY
Physical and Rehabilitation Therapy procedures
CODE TYPE
Timed-based code
ADD-ON CODE
97130
It should be used when any massage technique is performed on the patient in a clinical setting by qualified healthcare professionals. The qualified healthcare professionals include:
- Physical Therapist
- Occupational Therapist
- Chiropractors
- Physical Therapist Assistant
- Occupational Therapy Assistant
- Physician
Sometimes These techniques are considered therapy services when furnished by a Physical Therapist, Occupational or Speech Therapist, and required therapy modifier (GP, GN, GO, CO, CQ). However, these are not therapy services when provided by practitioners that are not therapists e.g. physicians, clinical nurse specialists, nurse practitioners, physician assistants, and psychologists, and do not require therapy modifiers.
CODING GUIDELINES
- One-on-one therapy code
- Initial 15 minutes of cognitive therapy
PHYSICAL THERAPY MODIFIERS
Below mentioned modifiers are used when services are provided for the respective plan of care:
| MODIFIERS | PLAN OF CARE |
|---|---|
| GP | Outpatient Physical Therapy |
| GO | Outpatient Occupational Therapy |
| GN | Outpatient Speech-Language Pathology |
| CQ | Outpatient Physical Therapy by a Physical Therapist Assistant (completely or partially) |
| CO | Outpatient Occupational Therapy by an Occupational Therapy Assistant (completely or partially) |
TOTAL NO. OF BILLABLE UNITS
Only 1 unit is allowed to bill per DOS, however, additional time spent by the therapist is billed using add-on code 97130 .
