The occupational therapy evaluations are structured the same as physical therapy.
- 97165 (low complexity)
- 97166 (moderate complexity)
- 97167 (high complexity)
- 97168 (re-evaluation)
Minimum requirements for initial evaluations are:
- Occupational profile and client history (medical and therapy)
- Assessments of occupational performance
- Clinical decision making
- Development of plan of care
Important:
- These codes have a typical time associated with them. These are not time-based code. That is a guide only. Do not code by time.
- For 2017, Medicare will pay the initial evaluation codes at the exact same rate. However, it is imperative that these services be coded correctly so they can be valued accurately next year.