Name of Manual - Blue Cross and Blue Shield of Minnesota

Physical Therapy
Evaluation Codes
Coding Policies and Guidelines (Rehabilitative Services)
Physical therapists evaluation and re-evaluation services should be
submitted using CPT codes 97001 and 97002.
Code Category Units of Service
97001-97002 Evaluation and re-evaluation 1 unit
These codes may be reported separately if the patient’s condition
requires significant separately identifiable services, above and
beyond the usual pre-service and post-service work associated with
the procedure performed.
The modifier -25 (significant, separately identifiable evaluation
and management service by the same physician on the same day as
the procedure or other service) is not valid with the physical
therapy (PT) evaluations and re-evaluation codes 97001-97002.
The evaluation or re-evaluation codes will be allowed, as
appropriate, when billed with other physical or occupational
services on the same date. Because the modifier -25 is not valid
with 97001-97002, if submitted, the service will be denied.
Occupational Therapy Listed below are the CPT physical medicine and rehabilitation
codes and additional codes that occupational therapists may
submit.
Code Category Units of Service
97010-97028 Modalities, supervised 1 unit for each modality
97032-97036 Modalities, constant
attendance
97039 Modality, constant
attendance, unlisted
1 unit for each 15
minutes
1 unit
97110-97140 Therapeutic procedures 1 unit for each 15
minutes
97150 Therapeutic
procedure(s), group
1 unit
97530-97542 Therapeutic procedures 1 unit for each 15
minutes
97545 Therapeutic procedures 1 unit
97546 Therapeutic procedures 1 unit for each additional
60 minutes
97597-97606 Active wound
management
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (03/19/12)
Unit per session
11-3