Coding and Billing for Outpatient Rehab Made Easy

❚❘❘ CPT codes
92627—Each additional 15 minutes of 92626. List separately, in addition to code for
primary procedure. You will need to go more than eight minutes past the hour to bill for
this code.
97001—Physical therapy evaluation (untimed).
97002—Physical therapy reevaluation (untimed).
97003—Occupational therapy evaluation (untimed).
97004—Occupational therapy reevaluation (untimed).
97005—Athletic training evaluation (untimed). This code is not a reimbursable service
under Medicare and most other payers.
97006—Athletic training reevaluation (untimed). This service is not reimbursable under
Medicare and most other payers. 3,5
Tip: Even though evaluations may take 45 or 60 minutes, suppliers and providers may
only bill for one unit in most cases. In order to track productivity, many facilities will
mark each 15 minutes spent with a patient as a unit to keep a record of a therapist’s
workload, but be careful that documentation stays in-house only.
Speech central nervous system and psychological assessments/tests
96101—Psychological testing (includes psycho-diagnostic assessment of emotionality,
intellectual abilities, personality, and psychopathology, e.g., MMPT, Rorschach, WAIS)
per hour of the psychologist’s or physician’s time—both face-to-face time with the
patient and time interpreting test results and preparing the report.
© 2006 HCPRO, INC. CODING AND BILLING FOR OUTPATIENT REHAB MADE EASY
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