Top CPT Codes for Occupational Therapy [2024 Billing Guide] (2024)

Occupational therapists (OTs) help patients with not just movement but also regaining the ability to perform essential daily tasks, like dressing or preparing meals. They help patients recover their independence, contributing to a higher quality of life.

As a therapist or biller, you play a part in bringing in full reimbursement for your OT services… And that means knowing your way around the top CPT codes for occupational therapy.

Take a look at the following list of top occupational therapy CPT codes to ensure accurate billing, maximize reimbursement potential, and contribute to your practice’s financial stability.

Mastering Occupational Therapy Billing with CPT Codes

The American Medical Association (AMA) describesCurrent Procedural Terminology (CPT®) codes as a uniform language for healthcare professionals and billers to document medical treatments. Using these codes can make the documentation and billing processes much more efficient and accurate, and ensure that services are accurately reimbursed.

Most OT CPT codes are time-based, reflecting the time spent directly with the patient. The standard unit is measured in 15-minute increments.

💯 Practical Advice
Remember the 8-minute rule, which is used by Medicare and other federal payers, and some private insurance companies.

Common CPT Codes for Occupational Therapy

Occupational therapy encompasses a diverse range of interventions, and so do the correlating CPT codes. Here’s a breakdown of some of the most commonly used CPT codes in occupational therapy practices, including codes for evaluation, modalities, therapeutic procedures, tests, remote therapeutic monitoring, and more.

Occupational Therapy Evaluation CPT Codes

OT evaluations are the first step to assessing a patient’s needs and developing a treatment plan.There are three evaluation codes for OT depending on the level of complexity, plus another code for re-evaluations.The level of complexity is determined by evaluating the patient as well as reviewing their medical history.

97165: Occupational therapy evaluation, low complexity

A brief assessment and medical history review focusing on a specific problem, typically lasting 30-45 minutes.

97166: Occupational therapy evaluation, moderate complexity

A more comprehensive review of medical history, an occupational profile, and assessments addressing functional limitations, typically 45-60 minutes.

97167: Occupational therapy evaluation, high complexity

A complex evaluation and review of medical history that often involves multiple visits or assessments, which typically lasts over 60 minutes.

97168: Occupational therapy re-evaluation

Re-assessment of the patient when their condition has changed significantly, typically involving a review of previous therapy, updated assessments, and revised treatment goals.

OT Modalities

Often, a therapist utilizes physical tools or techniques—modalities—to elevate therapeutic outcomes. These modalities play a significant role in occupational therapy:

97010: Hot or cold packs therapy

97018: Paraffin bath

Immersion of hands, feet, or elbows in warm paraffin wax to increase blood flow, improve joint range of motion, and soothe stiffness.

97022: Whirlpool bath

Hydro-massage therapy that promotes circulation, reduces swelling (edema), and helps relax muscles and tissues.

97024: Diathermy

Use of deep heat using electromagnetic waves (like microwaves) to reduce pain and inflammation, increase blood flow, and promote muscle relaxation.

97026: Application of low-energy heat (infrared)

Radiant heat from infrared lamps or pads to increase circulation, promote tissue healing, and potentially alleviate pain and stiffness.

97032: Application of electrical stimulation

Use of electrical stimulation to targeted areas of the body for pain reduction, muscle strengthening, and facilitation of tissue healing.

97034: Therapeutic hot and cold baths

Alternating application of hot and cold water baths to an extremity that can help manage pain, reduce swelling, and improve circulation.

97035: Therapeutic ultrasound

Application of sound waves to generate deep heat within targeted tissues, reducing pain and inflammation and potentially improving muscle function.

G0283: Electrical stimulation (unattended) to one or more areas as part of a therapy plan of care

Application of electrical stimulation pads for muscle stimulation, pain relief, and/or improved circulation—specifically excluding wound care.

Therapeutic Procedures

Occupational therapy procedures are specific activities or interventions OTs use to help patients improve their ability to perform everyday tasks and activities. (Most will be timed and billed in 15-minute units.) Top therapeutic procedures in occupational therapy include:

97110: Therapeutic exercise

Activities to improve strength, range of motion, and muscular function (e.g. knee strengthening exercises after an injury).

97112: Neuromuscular re-education

Re-training a patient on movement, coordination, and posture through exercises like balancing on a wobble board to improve stability after a stroke.

97113: Aquatic therapy with therapeutic exercises

Exercises that utilize thebuoyancy of water to promote muscle stimulation with a low impact.

97116: Gait training

Exercises and activities, like practicing walking with a cane on uneven surfaces, aimed at strengthening muscles and improving mobility.

97140: Manual therapy techniques

Hands-on manual therapy techniques like massage, joint mobilization, or soft tissue manipulations to reduce pain and improve movement.

97150: Therapeutic procedures, group setting

Group therapy sessions that address shared goals and promote social interaction, with the therapist briefly offering each patient specific instruction or adjustments tailored to their plan of care. See our guide to billing for individual therapy vs. group therapy.

97530: Therapeutic activities to improve function, direct (one-on-one)

Therapeutically designed games, puzzles, and interventions that enhance cognitive and functional abilities.

97533: Sensory integrative techniques to enhance processing and adaptation to environmental demands

Activities or interventions used by therapists to help patients process and react to sensory information.

97535: Self-care or home management training

Equipping patients with practical skills for independent living, technology, and self-care.

97537: Community or work reintegration training

Supporting work and social reintegration through daily living skills training.

97542: Wheelchair management

Training patients in safe and effective wheelchair use through education, assessments, and fittings.

Other Common Occupational Therapy CPT Codes

Occupational therapy includes a wide range of interventions, including evaluations, therapeutic exercises, neuromuscular re-education, manual therapy, therapeutic activities, self-care, cognitive skills training, and prosthetic training.

Tests, Assessments, and Measurements

97750:Muscle function performance/measurement test with direct patient contact and report
97755:Assistive technology assessment to improve function/accessibility with direct patient contact
96110:Developmental screening, such as a speech and language delay screen with scoring report
92612:Flexible endoscopic evaluation of swallowing by cine or video recording
96125:Standardized cognitive performance testing (per hour of face-to-face administration as well as time interpreting results and preparing report)
96127:Brief emotional/behavioral assessment (for conditions such as depression or ADHD) with scoring and report

Wound Care Management

97597:Wound cleaning and removal of dead material, including topical applications, wound assessment, and instructions for ongoing care; total wound surface area: first 20 sq. cm. or less
97598:Each additional 20 sq. cm., or part thereof (list separately in addition to code for primary procedure)
97602:Removal of devitalized tissue, cleaning, without anesthesia (e.g., wet-to-moist dressings, enzymatic, abrasion, larval therapy), including topical applications, wound assessment, and instructions for ongoing care
97605:Negative pressure wound therapy (e.g., vacuum assisted drainage collection), including topical applications, wound assessment, and instructions for ongoing care; total wound surface area less than or equal to 50 sq. cm
97606:Negative pressure wound therapy (e.g., vacuum assisted drainage collection), including topical applications, wound assessment, and instructions for ongoing care; Total wound surface area greater than 50 sq. cm
97610:Low frequency, non-contact, non-thermal ultrasound, including topical applications, when performed, wound assessment, and instructions for ongoing care

Remote Therapeutic Monitoring

98975:Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response; initial set-up and patient education on use of equipment
98976:Device supply with scheduled recordings and/or programmed alerts to monitor respiratory system, each 30 days
98977:Device supply with scheduled recordings and/or programmed alerts to monitor musculoskeletal system, each 30 days
98980:Remote therapeutic monitoring treatment management services, physician, or other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient or caregiver during the calendar month; first 20 minutes
98981:Each additional 20 minutes (List separately in addition to code for primary procedure)

Other Therapeutic Treatments and Interventions

97129:Therapeutic interventionsfocusing on cognitive training and compensation strategies to improve daily functioning
97124:Massage treatmentsto manipulate the soft tissues of the body for therapeutic purposes
97760:Orthotics management and training (including assessment and fitting when not otherwise reported), upper extremities, lower extremities and/or trunk, initial orthotics encounter
92526:Treatment of swallowing dysfunctionand/or oral function for feeding

💯 Practical Advice
For additional resources, check out the AMA’s 2024 Commonly Used OT CPT Codesor AOTA’s Coding and Billing Resources. Don’t miss our guide to ICD-10 Codes for Occupational Therapy and the Most Common Codes and Billing Modifiers in Rehab Therapy.

New: Caregiver Training

Recognizing the crucial role of caregivers, new codes were introduced in 2024 to support caregiver training and education provided by OTs. These three new codes report time spent training caregivers to assist patients with daily activities. All codes are face-to-face with the caregiver, without the patient present:

97550: Caregiver Training Without the Patient Present (initial 30 minutes)
97551: Caregiver Training Without the Patient Present (each additional 15 minutes)
97552:Group caregiver training (untimed)

Common Modifiers Used in OT

Occupational therapy services often require specific modifiers to accurately describe and bill for the services provided. Commonly used modifiers include:

GO:Service delivered personally by an occupational therapist or under an outpatient occupational therapy plan of care
CO:Outpatient physical therapy services furnished in whole or in part (10% or more) by an occupational therapist assistant (OTA). See the Centers for Medicare & Medicaid Services (CMS) website to review details and billing examples oncalculating timed billing on services provided by an OTA.
59:Clarifies a service is separate and distinct from other services/procedures that were performed during the same session.

Other modifiers that might be required include:

TF:(intermediate level of care) should be indicated when submitting claims for services provided by certified OT assistants under general supervision. Don’t include TF on prior authorization (PA) requests.
TL:should be indicated when submitting claims for Birth to 3 services provided in the natural environment of a Birth to 3 member. Don’t include TL on PA requests.
GT:used to identify services provided through teletherapy (interactive audio and video telecommunication systems where the therapist and patient interact remotely but not necessarily in real-time).
95: used to identify synchronous teletherapy services delivered through real-time interactive audio and video telecommunication systems.

Not all insurers require use of every modifier. Be sure to review each payor’s requirements and keep track of any changes or updates.

Staying Up to Date on CPT Code Changes

This list of common OT CPT codes is just a starting point. Whether it’s new CPT codes or revisions to existing ones, staying informed and up to date ensures your billing practices remain accurate, efficient, and compliant. Consider adopting specialized billing software built with OTs in mind, to streamline your processes and minimize errors.

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