The new codes for physical therapy evaluations are 97161–97164.
- 97161 (low complexity)
- 97162 (moderate complexity)
- 97163 (high complexity)
- 97164 (re-evaluation)
Minimum documentation requirements are:
- History
- Examination
- 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.