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CPT 97163: Physical Therapy Evaluation, High Complexity

CPT code 97163 denotes a high-complexity physical therapy evaluation characterized by a multi-factor patient history, an unstable clinical presentation, and examination of four or more body-function or activity elements using standardized tests and measures. Typically delivered in an outpatient or ambulatory rehabilitation setting, this evaluation commonly involves about 45 minutes of face-to-face time and reflects advanced clinical decision-making.

This code matters nationally because it differentiates levels of clinical complexity in therapy evaluations, which affects documentation expectations, claim adjudication, and resource allocation across provider settings. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Payor policies govern medical necessity criteria, time and complexity thresholds, and allowable sites of service for billing 97163.

Readers will find a concise explanation of the clinical definition and service context for 97163, a summary of common coverage considerations across major national payers, and connections to related services used in therapy episodes. The content clarifies what the code represents, typical encounter characteristics, and where to look for payer-specific policy language. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 97163 describes a physical therapy evaluation of high complexity. The service includes a patient history with three or more personal factors or comorbidities that influence care, assessment of a clinical status with unstable and unpredictable characteristics, and an examination of four or more elements related to body structure and function and activity limitations (for example, joint mobility, muscle performance, gait, and neuromuscular function). The evaluation uses standardized tests and measures and requires clinical decision-making of high complexity.

Service type: Physical therapy evaluation, high complexity
Typical site of service: Outpatient physical therapy clinic or comparable ambulatory rehabilitation setting where a physical therapist provides face-to-face evaluation (typically a 45-minute encounter involving the patient, family, or both).

National Reimbursement Benchmarks

Medicare's national mean rate for CPT 97163 sits at $101.40, which is very close to BUCA’s average commercial mean of $150.30 — a difference of $48.90. This positions Medicare toward the lower end of commercial averages, while BUCA reflects a mid-market commercial benchmark. The proximity of Medicare’s central tendency (median $99 and 25th/75th percentiles at $96/$104) to its mean suggests a compact distribution around the low $100s.

Dispersion varies notably by payer: Blue Cross Blue Shield has the widest interquartile spread (P75–P25 = $93.00) indicating substantial variability across its network, while Aetna (P75–P25 = $55.80) and UnitedHealth Group (P75–P25 = $39.00) show narrower spreads. BUCA’s interquartile range is $75.70, and Cigna’s is $45.50, placing them in the mid-range of dispersion. These differences highlight how payer-specific contract variability affects the concentration of rates.

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CPT 97163: Physical Therapy Evaluation, High Complexity

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Billing Code Overview

Service type: Physical therapy evaluation, high complexity
Typical site of service: Outpatient physical therapy clinic or comparable ambulatory rehabilitation setting where a physical therapist provides face-to-face evaluation (typically a 45-minute encounter involving the patient, family, or both).

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with progressive amyotrophic lateral sclerosis presents to an outpatient orthopedic/neuromuscular physical therapy clinic for initial evaluation. The patient reports increasing lower-extremity weakness, episodes of falls, and a chronic nonhealing right plantar foot ulcer with surrounding cellulitis. The physical therapist obtains an extensive history documenting three or more personal factors that affect care (progressive neuromuscular disease, recent weight loss, limited social support) and performs a comprehensive examination of four or more body structure and function elements (muscle strength testing, gait and balance assessment, joint range of motion, skin integrity/wound assessment). Standardized tests and measures such as the Timed Up and Go, 10-meter walk test, and Manual Muscle Testing are performed. Clinical decision-making is of high complexity due to unstable and unpredictable characteristics (declining motor function, frequent falls, risk of ulcer deterioration) and the therapist spends approximately 45 minutes face-to-face with the patient and family to establish goals, safety plan, and a skilled intervention plan.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same provider on the same day	When a physician documents a distinct E/M on the same day as the PT evaluation and payer allows modifier use for PT services in that jurisdiction
`52`	Reduced services	When the evaluation was started but stopped or not completed as originally intended (e.g., patient intolerance)
`59`	Distinct procedural service	When another distinct PT procedure is performed the same day and documentation supports separate distinct services
`62`	Two surgeons or split/shared billing (applicable in some facility billing scenarios)	Rarely used; when two qualified therapists share responsibility for the evaluation in facility billing contexts
`77`	Repeat procedure by another provider	When the evaluation is repeated by a different therapist for the same patient on the same day or later date as allowed by payer
`78`	Unplanned return to the operating/procedural suite (limited relevance)	Not typically used for PT evaluation but included when a related procedural event necessitates immediate re-evaluation in a facility setting
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	When the evaluation is delivered via live telehealth and payer accepts telehealth for PT evaluations
`GT`	Via interactive audio and video telecommunications system	Alternate telehealth modifier when required by payer for PT telehealth services
`KX`	Requirements specified in the medical policy have been met	When payer-required clinical criteria for medical necessity are documented (for example, prior authorization conditions met)
`59`	Distinct procedural service	When multiple distinct PT services on the same day require separation (duplicate entry retained for emphasis when clinically relevant)

Taxonomy Code	Specialty	Notes
`225100000X`	Physical Therapist	General PT providers who perform evaluations and plan of care
`2251P0200X`	Physical Therapist in Private Practice	Providers in outpatient private clinics commonly billing `97163`
`2251X0800X`	Orthopedic Physical Therapist	Therapists with orthopedic specialization who evaluate musculoskeletal and mobility impairments

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G12.23`	Amyotrophic lateral sclerosis involving lower limb	Progressive motor neuron disease causing weakness and gait impairment necessitating high-complexity PT evaluation
`G12.24`	Amyotrophic lateral sclerosis involving lower and upper limbs	Widespread limb involvement affecting mobility, balance, and function; drives need for comprehensive assessment
`G12.25`	Amyotrophic lateral sclerosis involving unspecified sites	ALS with variable presentation requiring individualized high-complexity decision-making
`L97.115`	Non-pressure chronic ulcer of right heel and midfoot with unspecified severity	Chronic lower-extremity wound that impacts mobility and wound care planning during PT evaluation
`L97.116`	Non-pressure chronic ulcer of right heel and midfoot with unspecified severity, infected	Infected ulcer increases clinical complexity and modifies plan of care and safety considerations
`L97.118`	Non-pressure chronic ulcer of right heel and midfoot with unspecified severity, with necrosis	Tissue necrosis adds complexity to wound management and mobility recommendations
`L97.125`	Non-pressure chronic ulcer of left heel and midfoot with unspecified severity	Contralateral chronic ulcer affecting ambulation and orthotic/footwear planning
`L97.126`	Non-pressure chronic ulcer of left heel and midfoot with infection	Infection increases need for monitoring and interdisciplinary coordination
`L97.128`	Non-pressure chronic ulcer of left heel and midfoot with necrosis	Necrotic tissue escalates clinical decision-making and safety planning
`L97.215`	Non-pressure chronic ulcer of right ankle with unspecified severity	Ankle ulcer affecting gait and mobility interventions
`L97.216`	Non-pressure chronic ulcer of right ankle with infection	Infection complicates rehabilitation progression
`L97.218`	Non-pressure chronic ulcer of right ankle with necrosis	Necrosis requires altered weight-bearing and wound care strategies
`L97.225`	Non-pressure chronic ulcer of left ankle with unspecified severity	Left-sided ulcer that impacts bilateral gait analysis and interventions
`L97.226`	Non-pressure chronic ulcer of left ankle with infection	Infection necessitates close monitoring and may limit interventions
`L97.228`	Non-pressure chronic ulcer of left ankle with necrosis	Advanced tissue injury affecting mobility planning
`L97.315`	Non-pressure chronic ulcer of right calf with unspecified severity	Calf ulcer contributing to mobility impairment and need for skin/wound assessment
`L97.316`	Non-pressure chronic ulcer of right calf with infection	Infection increases clinical complexity and interdisciplinary care
`L97.318`	Non-pressure chronic ulcer of right calf with necrosis	Necrosis influences weight-bearing and treatment choices
`L97.325`	Non-pressure chronic ulcer of left calf with unspecified severity	Left calf ulcer impacts gait symmetry and therapy goals
`L97.326`	Non-pressure chronic ulcer of left calf with infection	Infection modifies therapy frequency and precautions
`L97.328`	Non-pressure chronic ulcer of left calf with necrosis	Severe tissue loss requiring complex management
`L97.415`	Non-pressure chronic ulcer of right thigh with unspecified severity	Thigh ulcers affecting mobility and functional transfers
`L97.416`	Non-pressure chronic ulcer of right thigh with infection	Infection increases care coordination needs
`L97.418`	Non-pressure chronic ulcer of right thigh with necrosis	Necrosis necessitates specialized wound and mobility planning
`L97.425`	Non-pressure chronic ulcer of left thigh with unspecified severity	Left thigh involvement impacting transfers and gait
`L97.426`	Non-pressure chronic ulcer of left thigh with infection	Infection affects therapy progression
`L97.428`	Non-pressure chronic ulcer of left thigh with necrosis	Advanced ulceration requiring complex decision-making
`L97.515`	Non-pressure chronic ulcer of right buttock with unspecified severity	Pelvic/buttock ulcer influencing sitting tolerance and mobility goals
`L97.516`	Non-pressure chronic ulcer of right buttock with infection	Infection elevates clinical risk in rehabilitation
`L97.518`	Non-pressure chronic ulcer of right buttock with necrosis	Necrosis requiring modified treatment approaches
`L97.525`	Non-pressure chronic ulcer of left buttock with unspecified severity	Affects sitting tolerance and functional activities
`L97.526`	Non-pressure chronic ulcer of left buttock with infection	Infection increases monitoring and precautions
`L97.528`	Non-pressure chronic ulcer of left buttock with necrosis	Severe tissue loss influencing therapy planning
`L97.815`	Non-pressure chronic ulcer of right hip with unspecified severity	Hip-area ulcer that alters mobility and dressing needs
`L97.816`	Non-pressure chronic ulcer of right hip with infection	Infection complicates rehabilitation and wound care
`L97.818`	Non-pressure chronic ulcer of right hip with necrosis	Necrosis increases clinical complexity
`L97.825`	Non-pressure chronic ulcer of left hip with unspecified severity	Left hip ulcer impacting transfers and gait
`L97.826`	Non-pressure chronic ulcer of left hip with infection	Infection impacts therapy intensity and precautions
`L97.828`	Non-pressure chronic ulcer of left hip with necrosis	Advanced tissue injury requiring complex plan of care
`L97.915`	Non-pressure chronic ulcer of unspecified foot with unspecified severity	Foot ulcer that directly affects ambulation and orthotic needs
`L97.916`	Non-pressure chronic ulcer of unspecified foot with infection	Infection increases need for offloading and coordination
`L97.918`	Non-pressure chronic ulcer of unspecified foot with necrosis	Necrosis limits weight-bearing and rehab options
`L97.925`	Non-pressure chronic ulcer of unspecified lower leg with unspecified severity	Lower-leg ulcers that influence gait and strengthening plans
`L97.926`	Non-pressure chronic ulcer of unspecified lower leg with infection	Infection modifies frequency and safety precautions
`L97.928`	Non-pressure chronic ulcer of unspecified lower leg with necrosis	Necrosis necessitates complex wound and mobility strategies
`L98.415`	Non-pressure chronic ulcer of vulva with unspecified severity	Regional ulceration that may affect mobility or sitting tolerance
`L98.416`	Non-pressure chronic ulcer of vulva with infection	Infection increases interdisciplinary care needs
`L98.418`	Non-pressure chronic ulcer of vulva with necrosis	Severe soft tissue injury requiring complex planning
`L98.425`	Other specified non-pressure chronic ulcer of perineum with unspecified severity	Perineal ulcers affecting transfers and hygiene interventions
`L98.426`	Other specified non-pressure chronic ulcer of perineum with infection	Infection alters safe care and therapy choices
`L98.428`	Other specified non-pressure chronic ulcer of perineum with necrosis	Necrosis increases clinical complexity
`L98.495`	Non-pressure chronic ulcer of other part of trunk with unspecified severity	Trunk ulcers impacting positioning and mobility
`L98.496`	Non-pressure chronic ulcer of other part of trunk with infection	Infection complicates rehabilitation
`L98.498`	Non-pressure chronic ulcer of other part of trunk with necrosis	Necrosis requiring complex care coordination
`M48.061`	Spinal stenosis, lumbar region with neurogenic claudication, with radiculopathy	Lumbar spinal stenosis causing walking limitation and pain that necessitates high-complexity PT evaluation
`M48.062`	Spinal stenosis, lumbar region with neurogenic claudication, without radiculopathy	Neurogenic claudication causing impaired ambulation and functional decline addressed during PT evaluation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`G0283`	Unattended electrical stimulation, unattended, any type	May be used adjunctively in a treatment session after the evaluation for wound healing or pain modulation when ordered by the therapist and payer allows
`97110`	Therapeutic exercises, each 15 minutes	Commonly provided after the evaluation as an active treatment component focusing on strength, endurance, and mobility; billed in 15-minute units corresponding to direct treatment time

CPT 97164: Physical Therapy Re-evaluation, 20-Minute Face-to-Face

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same provider on the same day	When a physician documents a distinct E/M on the same day as the PT evaluation and payer allows modifier use for PT services in that jurisdiction
`52`	Reduced services	When the evaluation was started but stopped or not completed as originally intended (e.g., patient intolerance)
`59`	Distinct procedural service	When another distinct PT procedure is performed the same day and documentation supports separate distinct services
`62`	Two surgeons or split/shared billing (applicable in some facility billing scenarios)	Rarely used; when two qualified therapists share responsibility for the evaluation in facility billing contexts
`77`	Repeat procedure by another provider	When the evaluation is repeated by a different therapist for the same patient on the same day or later date as allowed by payer
`78`	Unplanned return to the operating/procedural suite (limited relevance)	Not typically used for PT evaluation but included when a related procedural event necessitates immediate re-evaluation in a facility setting
`95`	Synchronous telemedicine service rendered via real-time interactive audio and video	When the evaluation is delivered via live telehealth and payer accepts telehealth for PT evaluations
`GT`	Via interactive audio and video telecommunications system	Alternate telehealth modifier when required by payer for PT telehealth services
`KX`	Requirements specified in the medical policy have been met	When payer-required clinical criteria for medical necessity are documented (for example, prior authorization conditions met)
`59`	Distinct procedural service	When multiple distinct PT services on the same day require separation (duplicate entry retained for emphasis when clinically relevant)

Taxonomy Code	Specialty	Notes
`225100000X`	Physical Therapist	General PT providers who perform evaluations and plan of care
`2251P0200X`	Physical Therapist in Private Practice	Providers in outpatient private clinics commonly billing `97163`
`2251X0800X`	Orthopedic Physical Therapist	Therapists with orthopedic specialization who evaluate musculoskeletal and mobility impairments

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G12.23`	Amyotrophic lateral sclerosis involving lower limb	Progressive motor neuron disease causing weakness and gait impairment necessitating high-complexity PT evaluation
`G12.24`	Amyotrophic lateral sclerosis involving lower and upper limbs	Widespread limb involvement affecting mobility, balance, and function; drives need for comprehensive assessment
`G12.25`	Amyotrophic lateral sclerosis involving unspecified sites	ALS with variable presentation requiring individualized high-complexity decision-making
`L97.115`	Non-pressure chronic ulcer of right heel and midfoot with unspecified severity	Chronic lower-extremity wound that impacts mobility and wound care planning during PT evaluation
`L97.116`	Non-pressure chronic ulcer of right heel and midfoot with unspecified severity, infected	Infected ulcer increases clinical complexity and modifies plan of care and safety considerations
`L97.118`	Non-pressure chronic ulcer of right heel and midfoot with unspecified severity, with necrosis	Tissue necrosis adds complexity to wound management and mobility recommendations
`L97.125`	Non-pressure chronic ulcer of left heel and midfoot with unspecified severity	Contralateral chronic ulcer affecting ambulation and orthotic/footwear planning
`L97.126`	Non-pressure chronic ulcer of left heel and midfoot with infection	Infection increases need for monitoring and interdisciplinary coordination
`L97.128`	Non-pressure chronic ulcer of left heel and midfoot with necrosis	Necrotic tissue escalates clinical decision-making and safety planning
`L97.215`	Non-pressure chronic ulcer of right ankle with unspecified severity	Ankle ulcer affecting gait and mobility interventions
`L97.216`	Non-pressure chronic ulcer of right ankle with infection	Infection complicates rehabilitation progression
`L97.218`	Non-pressure chronic ulcer of right ankle with necrosis	Necrosis requires altered weight-bearing and wound care strategies
`L97.225`	Non-pressure chronic ulcer of left ankle with unspecified severity	Left-sided ulcer that impacts bilateral gait analysis and interventions
`L97.226`	Non-pressure chronic ulcer of left ankle with infection	Infection necessitates close monitoring and may limit interventions
`L97.228`	Non-pressure chronic ulcer of left ankle with necrosis	Advanced tissue injury affecting mobility planning
`L97.315`	Non-pressure chronic ulcer of right calf with unspecified severity	Calf ulcer contributing to mobility impairment and need for skin/wound assessment
`L97.316`	Non-pressure chronic ulcer of right calf with infection	Infection increases clinical complexity and interdisciplinary care
`L97.318`	Non-pressure chronic ulcer of right calf with necrosis	Necrosis influences weight-bearing and treatment choices
`L97.325`	Non-pressure chronic ulcer of left calf with unspecified severity	Left calf ulcer impacts gait symmetry and therapy goals
`L97.326`	Non-pressure chronic ulcer of left calf with infection	Infection modifies therapy frequency and precautions
`L97.328`	Non-pressure chronic ulcer of left calf with necrosis	Severe tissue loss requiring complex management
`L97.415`	Non-pressure chronic ulcer of right thigh with unspecified severity	Thigh ulcers affecting mobility and functional transfers
`L97.416`	Non-pressure chronic ulcer of right thigh with infection	Infection increases care coordination needs
`L97.418`	Non-pressure chronic ulcer of right thigh with necrosis	Necrosis necessitates specialized wound and mobility planning
`L97.425`	Non-pressure chronic ulcer of left thigh with unspecified severity	Left thigh involvement impacting transfers and gait
`L97.426`	Non-pressure chronic ulcer of left thigh with infection	Infection affects therapy progression
`L97.428`	Non-pressure chronic ulcer of left thigh with necrosis	Advanced ulceration requiring complex decision-making
`L97.515`	Non-pressure chronic ulcer of right buttock with unspecified severity	Pelvic/buttock ulcer influencing sitting tolerance and mobility goals
`L97.516`	Non-pressure chronic ulcer of right buttock with infection	Infection elevates clinical risk in rehabilitation
`L97.518`	Non-pressure chronic ulcer of right buttock with necrosis	Necrosis requiring modified treatment approaches
`L97.525`	Non-pressure chronic ulcer of left buttock with unspecified severity	Affects sitting tolerance and functional activities
`L97.526`	Non-pressure chronic ulcer of left buttock with infection	Infection increases monitoring and precautions
`L97.528`	Non-pressure chronic ulcer of left buttock with necrosis	Severe tissue loss influencing therapy planning
`L97.815`	Non-pressure chronic ulcer of right hip with unspecified severity	Hip-area ulcer that alters mobility and dressing needs
`L97.816`	Non-pressure chronic ulcer of right hip with infection	Infection complicates rehabilitation and wound care
`L97.818`	Non-pressure chronic ulcer of right hip with necrosis	Necrosis increases clinical complexity
`L97.825`	Non-pressure chronic ulcer of left hip with unspecified severity	Left hip ulcer impacting transfers and gait
`L97.826`	Non-pressure chronic ulcer of left hip with infection	Infection impacts therapy intensity and precautions
`L97.828`	Non-pressure chronic ulcer of left hip with necrosis	Advanced tissue injury requiring complex plan of care
`L97.915`	Non-pressure chronic ulcer of unspecified foot with unspecified severity	Foot ulcer that directly affects ambulation and orthotic needs
`L97.916`	Non-pressure chronic ulcer of unspecified foot with infection	Infection increases need for offloading and coordination
`L97.918`	Non-pressure chronic ulcer of unspecified foot with necrosis	Necrosis limits weight-bearing and rehab options
`L97.925`	Non-pressure chronic ulcer of unspecified lower leg with unspecified severity	Lower-leg ulcers that influence gait and strengthening plans
`L97.926`	Non-pressure chronic ulcer of unspecified lower leg with infection	Infection modifies frequency and safety precautions
`L97.928`	Non-pressure chronic ulcer of unspecified lower leg with necrosis	Necrosis necessitates complex wound and mobility strategies
`L98.415`	Non-pressure chronic ulcer of vulva with unspecified severity	Regional ulceration that may affect mobility or sitting tolerance
`L98.416`	Non-pressure chronic ulcer of vulva with infection	Infection increases interdisciplinary care needs
`L98.418`	Non-pressure chronic ulcer of vulva with necrosis	Severe soft tissue injury requiring complex planning
`L98.425`	Other specified non-pressure chronic ulcer of perineum with unspecified severity	Perineal ulcers affecting transfers and hygiene interventions
`L98.426`	Other specified non-pressure chronic ulcer of perineum with infection	Infection alters safe care and therapy choices
`L98.428`	Other specified non-pressure chronic ulcer of perineum with necrosis	Necrosis increases clinical complexity
`L98.495`	Non-pressure chronic ulcer of other part of trunk with unspecified severity	Trunk ulcers impacting positioning and mobility
`L98.496`	Non-pressure chronic ulcer of other part of trunk with infection	Infection complicates rehabilitation
`L98.498`	Non-pressure chronic ulcer of other part of trunk with necrosis	Necrosis requiring complex care coordination
`M48.061`	Spinal stenosis, lumbar region with neurogenic claudication, with radiculopathy	Lumbar spinal stenosis causing walking limitation and pain that necessitates high-complexity PT evaluation
`M48.062`	Spinal stenosis, lumbar region with neurogenic claudication, without radiculopathy	Neurogenic claudication causing impaired ambulation and functional decline addressed during PT evaluation

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`G0283`	Unattended electrical stimulation, unattended, any type	May be used adjunctively in a treatment session after the evaluation for wound healing or pain modulation when ordered by the therapist and payer allows
`97110`	Therapeutic exercises, each 15 minutes	Commonly provided after the evaluation as an active treatment component focusing on strength, endurance, and mobility; billed in 15-minute units corresponding to direct treatment time

CPT 97164: Physical Therapy Re-evaluation, 20-Minute Face-to-Face

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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OpenPayer

CPT 97163: Physical Therapy Evaluation, High Complexity

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Billing Code Overview

National Reimbursement Benchmarks

OpenPayer

CPT 97163: Physical Therapy Evaluation, High Complexity

Sign up for cpt 97163 policy alerts

Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 97163: Physical Therapy Evaluation, High Complexity

Sign up for cpt 97163 policy alerts

Billing Code Overview

National Reimbursement Benchmarks

CPT 97163: Physical Therapy Evaluation, High Complexity

Sign up for cpt 97163 policy alerts

Billing Code Overview

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical elements qualify an evaluation for CPT 97163?

How do reimbursement rates for 97163 compare between Medicare and commercial payers?

Which modifiers are noted as potentially applicable to CPT 97163?

Are there common services or CPT codes that often follow a 97163 evaluation?

Which diagnoses and payer considerations are associated with billing 97163?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What clinical elements qualify an evaluation for CPT 97163?

How do reimbursement rates for 97163 compare between Medicare and commercial payers?

Which modifiers are noted as potentially applicable to CPT 97163?

Are there common services or CPT codes that often follow a 97163 evaluation?

Which diagnoses and payer considerations are associated with billing 97163?

References