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Common CPT Codes: PT and OT (97110–97763)

presented by Rick Gawenda, PT

Accrediting Body:

Target Audience:

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Disclosure Statement:

Financial: Rick Gawenda receives compensation from Gawenda Seminars & Consulting, Inc., and MedBridge for this course.

Nonfinancial: Rick Gawenda has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Accreditation Check:
Video Runtime: 94 Minutes; Learning Assessment Time: 34 Minutes

This course will teach clinicians how to correctly select the most appropriate CPT code based on the documentation and intent of the intervention. CPT codes discussed in the course will include CPT codes 97110 to 97763. Examples of each CPT code will be provided to better assist the therapist and assistant in selecting the most appropriate CPT code.

Learning Objectives
  • Identify which CPT codes require one-on-one patient contact
  • Determine the difference between group therapy and one-on-one therapy
  • List what interventions are included within each CPT code
  • Apply how to use the orthotic and prosthetic management and training CPT codes and the L codes for orthotics
  • Determine how to bill for wound care services provided in the outpatient therapy setting
  • Analyze how to bill the caregiver training services CPT codes

Meet Your Instructor

Rick Gawenda, PT

Rick Gawenda is founder and president of Gawenda Seminars & Consulting, Inc. He graduated in 1991 with a Bachelor of Science in physical therapy from Wayne State University in Detroit. Rick is director of finance for a physical therapist-owned private practice with multiple offices located in Southern California. In addition, he was director of physical…

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Chapters & Learning Objectives

1. CPT Codes 97110 to 97140

This chapter will cover CPT codes 97110–97140 and provide examples of interventions that are included within each CPT code. In addition, the chapter will discuss the multilayer compression bandaging codes that may be utilized by therapists who provide lymphedema treatment.

2. CPT Code 97150: Group Therapy

Group therapy continues to be the most confusing and misunderstood CPT code utilized by providers of therapy services. This chapter will define CPT code 97150 and provide an example of when a therapist or assistant has two or more patients under their care at the same time and how in one instance, it would be group therapy, and in another instance, it would be individual therapy to each patient.

3. CPT Codes 97530 to 97546

This chapter will cover CPT codes 97530–97546 and provide examples of interventions that are included within each CPT code.

4. CPT Codes 97597 to 97610

This chapter will cover CPT codes 97597–97610 and provide examples of interventions that are included within each CPT code. The chapter will also teach participants which CPT codes are and are not payable under the Medicare program for providers who provide wound care under an outpatient therapy plan of care.

5. CPT Codes 97750 to 97763 and L Codes

This chapter will cover CPT codes 97750–97763 and provide examples of interventions that are included within each CPT code. CPT codes 97760 and 97761 were revised in 2018 and are now used differently than they were prior to 2018. CPT code 97763 is a brand-new code in 2018. Examples of when to use CPT code 97763 for orthotic and prosthetic management and training will be provided. This chapter will also discuss the L codes for orthotics provided under an outpatient therapy plan of care and teach participants what settings can bill the Medicare program for L codes without requiring a durable medical equipment supplier number.

6. Caregiver Training Services CPT Codes

This chapter will teach participants the caregiver training services CPT codes, including which codes are used for individual caregiver training services and which is used for group caregiver training services. In addition, this chapter will explain the requirements that must be met in order to bill the caregiver training services CPT codes to the Medicare program and other third-party payers.

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