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|Service Code |Relevant Therapy(s) |Definition |

|Physical Therapy Evaluation |PT |The physical therapist (PT) examines the patient/client. This includes taking comprehensive history, systems review, and tests and measures. Tests and |

|97001 USE FOR EVAL ON OR BEFORE 12/31/16 | |measures may include but are not limited to tests of range of motion, motor function, muscle performance, joint integrity, neuromuscular status, and review |

| | |of orthotic or prosthetic devices. The PT formulates an assessment, prognosis, and notes an anticipated intervention. |

|Physical Therapy Evaluation |PT |Low *Please refer to APTA Guidelines posted to Provider Resources |

|97161 USE FOR EVAL ON OR AFTER 1/1/17 | | |

|Physical Therapy Evaluation |PT |Moderate *Please refer to APTA Guidelines posted to Provider Resources |

|97162 USE FOR EVAL ON OR AFTER 1/1/17 | | |

|Physical Therapy Evaluation |PT |High *Please refer to APTA Guidelines posted to Provider Resources |

|97163 USE FOR EVAL ON OR AFTER 1/1/17 | | |

|Physical Therapy Re-Evaluation |PT |The physical therapist (PT) re-examines the patient/client to obtain objective measures of progress toward stated goals. Tests and measures include but are |

|97002 USE FOR RE-EVAL ON OR BEFORE | |not limited to those noted in 87001. The PT modifies the treatment plan as is indicated to support medical necessity of skilled intervention. |

|12/31/16 | | |

|Physical Therapy Re-Evaluation |PT |*Please refer to APTA Guidelines posted to Provider Resources |

|97164 USE FOR RE-EVAL ON OR AFTER 1/1/17 | | |

|Gait Training |PT |The clinician instructs the patient in specific activities that will facilitate ambulation and stair climbing with or without an assistive device. Proper |

|97116 | |sequencing and safety instructions are included when appropriate. This code requires direct contact and may be billed in 15-minute units. |

|Therapeutic Exercise |PT/OT |The clinician and/or patient perform therapeutic exercises to one or more body areas to develop strength, endurance, and flexibility. This code requires |

|97110 | |direct contact and may be billed in 15-minute units. |

|Neuromuscular Re-Education of Movement, |PT/OT |The clinician and/or patient perform activities to one or more body areas that facilitate reeducation of movement, balance, coordination, kinesthetic sense, |

|Balance, Coordination | |posture, and proprioception. This code requires direct contact and may be billed in 15-minute units. |

|97112 | | |

|Therapeutic Activities – Direct |PT/OT |The clinician uses dynamic therapeutic activities designed to achieve improved functional performance (e.g., lifting, pulling, bending). This code requires |

|97530 | |direct contact and can be billed in 15-minute units. |

|ADL, Self Care, Home Management Training |PT/OT |The clinician instructs and trains the patients in self-care and home management activities (e.g., ADL and use of adaptive equipment in the kitchen, bath, |

|97535 | |and/or care). Direct contact is required. This code can be billed in 15-minute units. |

|Cognitive Skills Development |OT |An occupational therapist or rehabilitation specialist works one-on-one with an individual to assist in the development of cognitive skills in individuals |

|97532 | |with inherited learning disabilities or in individuals who have lost these skills as a result of illness or brain injury. The individual often needs to |

| | |develop compensatory methods of processing and retrieving information when disability, illness or injury has affected these cognitive processes. Cognitive |

| | |skill development includes mental exercises that assist the patient in areas of attention, memory, perception, language, reasoning, planning, problem-solving|

| | |and related skills. |

|Service Code |Relevant Therapy(s) |Definition |

|Sensory Integration |OT |Sensory experience includes touch, movement, body awareness, sight, sound and the pull of gravity. The process of the brain organizing |

|97533 | |and interpreting this information is called sensory integration. Sensory integration provides a crucial foundation for later, more |

| | |complex learning and behavior. An occupational therapist or rehabilitation specialist works one-on-one with individuals with sensory |

| | |integration disorders to provide techniques for enhancing sensory processing and adapting to environmental demands. Sensory integration |

| | |disorders may be the result of a learning disability, illness or brain injury. |

|Occupational Therapy Evaluation |OT |The occupational therapist evaluates the patient. Various movements required for activities of daily living are examined. Dexterity, |

|97003 USE FOR EVAL ON OR BEFORE 12/31/16 | |range of movement, and other elements may also be studied. |

|Occupational Therapy Evaluation |OT |Low *Please refer to AOTA Guidelines posted to Provider Resources |

|97165 USE FOR EVAL ON OR AFTER 1/1/17 | | |

|Occupational Therapy Evaluation |OT |Moderate *Please refer to AOTA Guidelines posted to Provider Resources |

|97166 USE FOR EVAL ON OR AFTER 1/1/17 | | |

|Occupational Therapy Evaluation |OT |High *Please refer to AOTA Guidelines posted to Provider Resources |

|97167 USE FOR EVAL ON OR AFTER 1/1/17 | | |

|Occupational Therapy Re-Evaluation |OT |The occupational therapist re-evaluates the patient to gauge progress of therapy. Various movements required for activities of daily |

|97004 USE FOR RE-EVAL ON OR BEFORE 12/31/16 | |living are examined. Dexterity, range of movement, and other elements may also be studied. |

|Occupational Therapy Re-Evaluation | |*Please refer to APTA Guidelines posted to Provider Resources |

|97168 USE FOR EVAL ON OR AFTER 1/1/17 | | |

|Evaluation of Speech Fluency |ST |Evaluation of Speech Fluency (e.g., stuttering, cluttering) |

|92521 | | |

|Evaluation of Speech Sound Production |ST |Evaluation of Speech Sound Production (e.g., articulation, phonological process, apraxia, dysarthria) |

|92522 | | |

|Evaluation of Speech Sound Production with Evaluation of|ST |Evaluation of Speech Sound Production (e.g., articulation, phonological process, apraxia, dysarthria) with Evaluation of Language |

|Language Comprehension and Expression | |Comprehension and Expression (e.g., receptive and expressive language) |

|92523 | | |

|Behavioral and Qualitative Analysis of Voice and |ST |Behavioral and Qualitative Analysis of Voice and Resonance |

|Resonance | | |

|92524 | | |

|Service Code |Relevant Therapy(s) |Description |

|Treatment of Speech, Language, Voice, Communication – Individual |ST |Treatment of speech, language, voice, communication, and/or auditory processing disorder, individual |

|92507 | | |

|Treatment of Speech, Language, Voice, Communication – Group |ST |Treatment of speech, language, voice, communication, and/or auditory processing disorder, group, two or more |

|92508 | |individuals |

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