Coding and Billing for Outpatient Rehab Made Easy

CHAPTER 1
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Another option is to bill using CPT code 97750 (physical performance test or measure).
This is a timed code and is billed in 15-minute increments. It also requires a written
report. Check with your specific payer regarding which CPT code it wants billed. In addition,
make sure that the third-party payer covers ergonomic or worksite evaluations.
When billing private insurance carriers for electrical stimulation, should I use the Medicare code
G0283 or CPT code 97014?
CPT code 97014 is a Level I HCPCS code and G0283 is a Level II HCPCS code. The
AMA developed and copyrighted both codes.
On April 1, 2003, Medicare contractors began to require that providers use G0283 for
electrical stimulation for any reason other than wound care on all claims for Part B therapy
services. Most other private insurances only accept 97014 and do not recognize
G0283. There are some instances in which insurance companies aside from Medicare
now require G0283 instead of 97014, but this is currently the exception and not the rule.
If you need clarification regarding which code a specific payer wants, contact that company’s
provider inquiry department for further information.
Our facility needs clarification regarding aquatic therapy and group exercise. Here is the scenario: A
PT technician, under the direct supervision of a PT, performs therapeutic exercise with a group of
patients in the pool. The PT is also in the pool, but he provides one-on-one aquatic therapy to another
patient outside of the group. At the same time, this PT also supervises the PT technician. Can we
charge the patient receiving the one-on-one therapy for aquatic therapy (97113) and also charge the
patients receiving group therapy for group exercise (97150)?
Charge the patient working directly with the PT for one-on-one time. The PT would bill
the appropriate number of units of 97113 based on the amount of time spent with the
patient. Any services the PT technician provides to Medicare patients in the group setting
are nonbillable because he or she does not meet the qualifications of a PT or PTA under
Medicare rules and regulations. These services are also nonbillable by the PT under
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