Navigating Physical Therapy CPT Codes in 2021: What You Need to Know

As a physical therapist, understanding the current Common Procedural Terminology (CPT) codes is an essential part of providing quality care for patients. The CPT codes are a universal language that is used to communicate with insurance companies about the services you provide. In 2021, there are updates to the CPT codes that impact physical therapy. In this article, we will discuss what you need to know to navigate physical therapy CPT codes in 2021.

Understanding CPT Codes

CPT codes are used to describe medical, surgical, and diagnostic services that are provided to patients. These codes are created and maintained by the American Medical Association (AMA). The idea behind CPT codes is to provide a standardized language that can be used to describe the services that are provided to patients. This helps to ensure that insurance companies are paying for the appropriate services and that providers are being fairly compensated for their work.

CPT Codes for Physical Therapy

As a physical therapist, you will use CPT codes to describe the services you provide to your patients. There are several codes that are commonly used in physical therapy:

• 97161 - Physical therapy evaluation, low complexity
• 97162 - Physical therapy evaluation, moderate complexity
• 97163 - Physical therapy evaluation, high complexity
• 97164 - Re-evaluation of physical therapy established plan of care
• 97110 - Therapeutic exercises
• 97112 - Neuromuscular reeducation
• 97116 - Gait training therapy
• 97140 - Manual therapy

Updates to CPT Codes in 2021

For 2021, there are several updates to the CPT codes that impact physical therapy. One of the most significant changes is the addition of new codes for online digital evaluation and management services. These codes allow providers to offer virtual care to their patients, which is particularly important during the COVID-19 pandemic. Additionally, there are updates to the codes for therapeutic exercises, neuromuscular reeducation, and gait training.

Navigating CPT Codes

When navigating CPT codes, it is essential to consider the impact on patient care. While it may be tempting to choose codes that reimburse at higher rates, it is important to ensure that the codes accurately reflect the services provided to the patient. Inaccurate coding can lead to audits and potentially even fines. Additionally, when considering the impact on patient care, it is important to choose codes that reflect the care provided and that are in line with evidence-based practice.

Challenges of Navigating CPT Codes

One of the biggest challenges of navigating CPT codes is staying up to date with the changes. The AMA updates the codes annually, and it is essential to ensure that you are using the most current codes. Additionally, navigating the different codes and determining the appropriate codes for the services provided can be complex. It is essential to have a deep understanding of the codes and how they apply to physical therapy services.

Conclusion

Navigating physical therapy CPT codes in 2021 is essential for providing quality care to patients. It is important to have a deep understanding of the codes, stay up to date with changes, and consider the impact on patient care when choosing codes. By taking a thoughtful and informed approach to navigating CPT codes, physical therapists can ensure that they are providing the best possible care to their patients.