CPT 95852 Hand Range of Motion — Reimbursement | OpenPayer

Summary & Overview

CPT 95852: Hand Range of Motion Measurement

CPT code 95852 represents a focused clinical procedure to measure hand range of motion, a standardized assessment used to quantify joint mobility and functional status. Nationally, this code matters for documenting impairment, tracking recovery from injury or surgery, and supporting functional assessments used by clinicians, therapists, and payers. Accurate use of the code helps ensure consistent clinical records and contributes to appropriate claims processing.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the procedure, common sites of service, and payer coverage considerations. The publication outlines benchmarking and utilization patterns, coding and billing nuances, and relevant policy updates that affect reimbursement and documentation expectations. It also highlights how the measurement is used in care pathways for hand injuries, post-operative follow-up, and rehabilitation.

This summary provides clinicians, billing professionals, and policy analysts with the essential facts about CPT code 95852, including what the procedure captures, where it is typically performed, and which major payers are relevant to coverage discussions. Data not available in the input will be noted where applicable in the detailed sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare95852CPThand range of motionphysical assessmentrehabilitationoutpatient servicesfunctional measurementmedical billingdocumenting impairment

Billing Code Overview

CPT code 95852 documents a range of motion measurement of a hand. This procedure records how much movement exists at the joints of the hand and may include comparison to the contralateral side when applicable. The assessment quantifies active and/or passive motion to help characterize functional limitations and monitor recovery or progression.

Service Type: Physical/functional measurement

Typical Site of Service: Outpatient clinic, physician office, or rehabilitation setting

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45-year-old administrative assistant who presents to an outpatient orthopedic clinic with persistent stiffness and decreased mobility in the dominant right hand following a distal radius fracture three months earlier. The clinician performs a focused hand evaluation that includes inspection, palpation, and objective measurement of joint mobility using goniometry. The procedure 95852 is performed to measure active and/or passive range of motion of the wrist, fingers, and thumb; the provider documents degrees of motion for each joint, compares findings to the contralateral hand when appropriate, and records limitations affecting function such as decreased grip or difficulty with activities of daily living. Results are used to guide management including therapy, splinting, or reassessment for surgical referral. Typical workflow steps: referral or follow-up visit → history and focused exam → immobilization or wound check if applicable → formal range of motion measurement (95852) → documentation of measurements, comparison with the opposite side if clinically relevant, and development of next-step plan. Typical sites of service are outpatient clinic, physician office, and physical or occupational therapy departments. Typical patient scenarios include post-fracture stiffness, adhesive capsulitis of the wrist, tendon injuries with motion restriction, inflammatory arthritis with joint contractures, and pre- or post-operative functional assessments.

Coding Specifications

Modifier	Description	When to Use

CPT 95851: Range of Motion Measurement and Report for Extremities or Spine

CPT-95836-ECOG-ANALYSIS-FROM-IMPLANTED-NEUROSTIMULATOR

CPT 95836: Electrocorticogram Analysis from Implanted Neurostimulator

CPT-95857-EDROPHONIUM-TENSILON-TEST-MYASTHENIA-GRAVIS

CPT 95857: Edrophonium (Tensilon) Test for Myasthenia Gravis

Taxonomy Code	Specialty	Notes
207RC0000X	Orthopedic Surgery	Orthopedic surgeons commonly perform and document hand/wrist range of motion measurements.
207X00000X	Physical Medicine & Rehabilitation	Physiatrists frequently assess and document ROM to guide conservative management and rehab.
228100000X	Physical Therapist	Physical therapists perform serial ROM measurements during therapy sessions (billing via facility or therapist rules).
208000000X	Family Medicine	Primary care clinicians may perform `95852` during initial assessment or follow-up of musculoskeletal complaints.
363A00000X	Occupational Therapist	Occupational therapists commonly measure hand ROM for functional assessments and therapy planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M24.211`	Recurrent dislocation, right shoulder	Example of a joint instability diagnosis where ROM measurement is relevant for functional assessment (included as a representative shoulder-related code).
`M25.511`	Pain in right shoulder	Joint pain diagnoses often prompt objective ROM measurement to quantify impairment.
`M05.841`	Rheumatoid arthritis of right wrist with involvement of multiple sites	Inflammatory arthropathies commonly cause limited range of motion measured with `95852`.
`S62.501A`	Unspecified fracture of right wrist, initial encounter for closed fracture	Post-fracture ROM assessment is a common clinical scenario for `95852` during recovery.
`M21.631`	Contracture of right ankle, acquired	Joint contractures in any peripheral joint may be evaluated with range of motion measurement; analogous to hand/wrist utilities.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97001`	Physical therapy evaluation	Often performed before serial ROM measurements to establish baseline functional status and therapy plan.
`97110`	Therapeutic exercises to develop strength and endurance, range of motion and flexibility	Often performed after ROM assessment to improve motion when deficits are documented with `95852`.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder) — note: for small joints use `20610` variant per payer rules	May be performed same day for diagnostic or therapeutic reasons; use of `59` may be required to indicate distinct service from ROM measurement.
`99080`	Special reports such as insurance forms and medical-legal documentation	Used when ROM measurements documented with `95852` are included in detailed reports for insurers or legal cases.
`97760`	Orthotic management and training, initial encounter	May follow ROM measurement when splinting or orthotic devices are prescribed based on documented motion limitations.

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