CPT Code 97110 Description and Fee Schedule (2024)

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In medical billing and coding, CPT codes are critical in ensuring accurate reimbursement for healthcare services. One of the most commonly used codes is CPT code 97110, which refers to therapeutic exercises that improve strength, endurance, flexibility, and balance.

This article will explore the definition of CPT code 97110, its proper usage, and frequently asked questions. We will also discuss the benefits of using this code in medical billing and coding and some examples of its application in different healthcare settings.

So, let’s get started!

Table of Contents

What is CPT Code 97110?

CPT code 97110 is a Current Procedural Terminology (CPT) code that describes therapeutic exercises designed to improve a patient’s strength, endurance, flexibility, and balance. This code is commonly used in physical therapy and rehabilitation settings but can also be applied in other healthcare settings where therapeutic exercise is used to treat a patient’s condition.

When to Use CPT Code 97110?

CPT code 97110 should be used when a healthcare provider performs therapeutic exercises to improve a patient’s strength, endurance, flexibility, or balance. This code is often used in physical therapy and rehabilitation settings but can also be applied in other healthcare settings where therapeutic exercise is used to treat a patient’s condition.

Here are some examples of when to use 97110:

  • A physical therapist helps a patient recover from a knee injury by designing a customized exercise program that focuses on strengthening the muscles around the knee joint.
  • An occupational therapist works with a patient who has suffered a stroke to improve their balance and coordination through therapeutic exercises.
  • A chiropractor helps patients with chronic back pain by using therapeutic exercises to improve their flexibility and range of motion.

How to Use CPT Code 97110?

To use code 97110, the healthcare provider must perform therapeutic exercises that meet the code’s definition. These exercises should be designed to improve a patient’s strength, endurance, flexibility, or balance and must be documented in the patient’s medical record.

Here are some steps to follow when using procedure code 97110:

  1. Evaluate the patient’s condition and identify the areas that need improvement.
  2. Design a customized exercise program to improve the patient’s strength, endurance, flexibility, or balance.
  3. Perform the therapeutic exercises as designed, and document them in the patient’s medical record.
  4. Use CPT code 97110 when billing for therapeutic activities.

Fee Schedule 2023 for CPT 97110

As per CMS the fee schedule for 2023 is

HCPCS CodeShort DescriptionNon-Facility PriceFacility PriceNon-Facility Limiting ChargeFacility Limiting Charge
97110Therapeutic exercises$29.82$29.82$32.58$32.58
Also Read: 5 Ways to Improve Patient Retention

FAQs

Q1. Is CPT code 97110 reimbursable by insurance?

Ans. Yes, CPT code 97110 is reimbursable by insurance as long as the therapeutic exercises meet the code’s definition and are medically necessary.

Q2. Can 97110 cpt code be used with other codes?

Ans. Yes, Procedure 97110 can be used with other regulations as long as they are appropriate and medically necessary. For example, it can be used with evaluation and management codes or with other therapy codes.

Q3. What are the benefits of using CPT code 97110?

Ans. Using CPT code 97110 can benefit both healthcare providers and patients. Providers can accurately bill for the services they Provide, ensuring proper reimbursement for their work. Meanwhile, patients can receive the necessary therapeutic exercises to improve their condition, ultimately leading to better health outcomes.

Q4. Are there any limitations to using CPT 97110?

Ans. While Procedure code 97110 can be used in various healthcare settings, it is essential to ensure that the therapeutic exercises performed meet the code’s definition and are medically necessary. Overusing or misusing the code can lead to denied claims and potential legal issues.

Q5. Can patients perform therapeutic exercises on their own?

Ans. While therapeutic exercises can benefit patients, they must be performed under the guidance of a healthcare professional. Improperly performed activities can lead to further injury or harm to the patient.

Conclusion:

CPT code 97110 is necessary for medical billing and coding for therapeutic exercises designed to improve a patient’s strength, endurance, flexibility, and balance. Its proper usage can ensure accurate reimbursement for healthcare providers and provide necessary therapeutic exercises for patients.

By understanding the definition, usage, and frequently asked questions about Procedure code 97110, healthcare providers can effectively apply the code in their work, ultimately leading to better patient health outcomes.