Physical therapy CPT code lookup
The outpatient set is small enough to hold in your head and easy to bill wrong anyway, because the trap is not the code — it is whether the code is timed. Filter by group, or type a number.
15 of 15 codes
- 97161untimed · 1 unit
PT evaluation, low complexity
A first visit with a stable presentation, one or two elements of body-structure involvement and no personal factors complicating the picture.
watch Complexity is decided by the elements you documented, not by how long the visit took.
- 97162untimed · 1 unit
PT evaluation, moderate complexity
An evolving presentation with three or more elements and a clinical decision of moderate complexity. The tier most outpatient evaluations land in.
watch If every evaluation you bill is 97162, expect the pattern to be noticed.
- 97163untimed · 1 unit
PT evaluation, high complexity
An unstable or unpredictable presentation, four or more elements and comorbidities that change the plan.
watch The record has to show what made it unstable, in the assessment, not just the history.
- 97164untimed · 1 unit
PT re-evaluation
A formal re-examination triggered by new clinical findings or a failure to progress — not the routine progress note.
watch A scheduled ten-visit check is a progress note. A re-evaluation needs a reason.
- 97110timed · 15 min
Therapeutic exercise
Exercise to develop strength, endurance, range of motion or flexibility in one or more body areas.
watch The commonest code in outpatient PT and the commonest one denied for reading like a gym log.
- 97112timed · 15 min
Neuromuscular re-education
Re-education of movement, balance, coordination, kinaesthetic sense, posture and proprioception.
watch Needs a neuromuscular deficit named in the objective, not just a wobbly patient.
- 97116timed · 15 min
Gait training
Gait training, including stair negotiation, with or without an assistive device.
watch Walking a patient down the corridor is not gait training unless you changed something.
- 97140timed · 15 min
Manual therapy
Mobilisation and manipulation, manual lymphatic drainage and manual traction, one or more regions.
watch The 59/XS modifier question against 97530 in the same visit turns on separate body regions or separate time.
- 97530timed · 15 min
Therapeutic activities
Dynamic activities to improve functional performance — lifting, carrying, reaching, transfers.
watch The distinction from 97110 is functional task versus isolated impairment.
- 97535timed · 15 min
Self-care / home management training
Training in activities of daily living, compensatory technique, safe use of adaptive equipment.
watch Handing over a printed home programme is not, by itself, this code.
- 97012untimed · 1 unit
Mechanical traction
Supervised mechanical traction, billed once per visit regardless of minutes.
watch Untimed. One unit, however long the table ran.
- 97014untimed · 1 unit
Electrical stimulation, unattended
Unattended electrical stimulation. Medicare wants G0283 instead in most settings.
watch Unattended means unattended: constant attendance codes are a different family.
- 97035timed · 15 min
Ultrasound
Therapeutic ultrasound applied with constant attendance.
watch Timed and constant-attendance — the minutes must be your minutes.
- 97032timed · 15 min
Electrical stimulation, manual
Attended electrical stimulation applied one-to-one.
watch If the patient is alone with the unit, this is the wrong code.
- 97750timed · 15 min
Physical performance test
A measured functional capacity test with a written report.
watch The written report is part of the code. No report, no code.
Timed or untimed decides everything downstream
An untimed code is one unit however long you spent. A timed code is counted in 15-minute blocks against the day’s total minutes, which is why the units calculator asks for minutes and not for units. Mixing the two up is the single most common reason a claim comes back.
Evaluation tiers are decided by elements
97161 through 97163 are graded on history, examination, clinical presentation and decision making — not on the clock. Time is a tie-breaker, not the criterion, and a chart full of 97162 with no variation reads as a template rather than a judgement.
Modifier 59 and its X subsets
The pair that generates the most questions is 97140 with 97530 in the same visit. They are separable when they were performed on different body regions, or in clearly separate blocks of time, and the note has to say which. XS (separate structure) and XU (unusual non-overlapping service) are the more precise replacements for a blanket 59.
Red flag — refer out
A code set is a billing question. Progressive weakness, saddle anaesthesia, bladder change or unexplained systemic symptoms are not — stop, and refer.
CPT is a trademark of the American Medical Association. The lines above are our own plain summaries of what each code covers, not the AMA descriptors. Unit rules read from CMS Pub. 100-04 Medicare Claims Processing Manual, Chapter 5, §20.2.C — Counting Minutes for Timed Codes in 15 Minute Units on 2026-09-04.
Sources
- American Medical Association — Current Procedural Terminology (CPT) — CPT is an AMA trademark; the official descriptors are the AMA's and are paraphrased here, never reproduced · read 2026-09-04
- CMS Pub. 100-04, Medicare Claims Processing Manual, Chapter 5 §20.2.C — counting minutes for timed codes in 15-minute units · read 2026-09-04
- CMS Change Request 13437 — 2026 annual update to the per-beneficiary therapy thresholds · read 2026-09-04
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