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97110 CPT Code: Everything You Need to Know

Written by PtEverywhere | Jun 16, 2025 4:00:00 AM

When it comes to billing for therapeutic exercise, no CPT code is more central to physical therapy practices than 97110. Used in a wide range of clinical settings, CPT code 97110 allows therapists to get reimbursed for individualized, one-on-one therapeutic exercises aimed at improving strength, endurance, flexibility, and range of motion. But to use this code effectively and ensure compliance, it’s crucial to understand its proper application, documentation, and billing strategies.

This guide covers everything physical therapy professionals and practice owners need to know about 97110 CPT code use, documentation requirements, modifiers, and how to simplify the process with smarter practice management tools.

What is CPT Code 97110?

The 97110 CPT code description is as follows:

"Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength, endurance, range of motion and flexibility."

This means any therapeutic activity that focuses on improving a patient’s physical capacities through prescribed, targeted exercises qualifies for 97110 billing—provided it's done with direct, one-on-one contact.

Examples of qualifying exercises include:

  • Resistance training using bands or weights

  • Range-of-motion stretches for post-surgical patients

  • Cardiovascular conditioning using a treadmill or stationary bike

  • Core stabilization drills for back pain

The 97110 CPT code can be used across various diagnoses, from orthopedic and neurological conditions to general deconditioning or sports injuries.

When and How to Bill for 97110 CPT Code

Billing correctly for 97110 CPT code hinges on time. The code is considered a "timed code", and therefore follows the 8-minute rule:

  • 8 to 22 minutes = 1 unit

  • 23 to 37 minutes = 2 units

  • 38 to 52 minutes = 3 units

And so on.

To qualify, time spent must include only the direct one-on-one time performing therapeutic exercise with the patient. Time not spent in direct contact—such as charting or patient prep—does not count.

Documentation Best Practices

Proper documentation is essential for audit-proof billing and maximizing reimbursement. Here's what to include:

  • Type of exercise: Describe each exercise performed (e.g., seated leg press, scapular retraction).

  • Body part(s): Indicate the targeted muscle groups or joints.

  • Purpose: Explain the functional goal (e.g., improve ROM to support walking).

  • Progress metrics: Include objective data like strength grades or degrees of motion.

  • Time spent: Record minutes for each exercise to validate the unit count.

  • Medical necessity: Show how the treatment is related to the patient's impairments and functional limitations.

Incomplete or vague notes are one of the top reasons for claim denials.

97110 CPT Code Reimbursement

97110 CPT code reimbursement rates vary based on the payer, location, and provider type. Medicare typically reimburses around $30–40 per unit, while private insurers may offer between $35 and $50 per 15-minute unit.

To optimize reimbursement:

  • Follow payer guidelines closely

  • Use appropriate modifiers (see below)

  • Maintain detailed, compliant documentation

Modifier Use With 97110

Modifiers help clarify the circumstances of a claim and can prevent denials when multiple services are billed on the same day.

Common modifiers used with CPT code 97110 include:

  • GP: Services delivered under a physical therapy plan of care

  • GO: Services under an occupational therapy plan

  • CQ: Services provided in part by a therapy assistant

  • KX: Services medically necessary beyond Medicare therapy thresholds

  • 59: Distinct procedural service (used when billing multiple timed codes)

For example, if you're billing 97110 alongside 97530 (therapeutic activities), use modifier 59 if both were provided during separate, non-overlapping portions of the session.

Common Mistakes and How to Avoid Them

  1. Not meeting the time requirement – Always track time accurately.

  2. Vague documentation – Use clear, measurable language.

  3. Not applying appropriate modifiers – Especially critical for services delivered concurrently.

  4. Failing to prove medical necessity – Every claim should tie exercise back to function.

Audits and denials often result from one or more of these missteps.

Why and How PtEverywhere Can Help

PtEverywhere is designed specifically to help physical therapy professionals and practice owners simplify and optimize the entire billing process for therapeutic services, including 97110.

Time Tracking: Built-in timers to ensure compliance with the 8-minute rule

Smart Documentation: Structured templates that prompt for all required details

Modifier Suggestions: Automated modifier prompts to reduce claim errors

Real-Time Coding Alerts: Prevents overlapping billing of timed services

Reimbursement Insights: See payer-specific trends to optimize collections

Integrated Workflows: One platform for charting, coding, scheduling, and billing

 

Using PtEverywhere means less time on admin and more time with patients, all while reducing denials and improving cash flow.

Conclusion

The 97110 CPT code is a cornerstone of outpatient physical therapy billing, but it's also a code that demands precise documentation, accurate timing, and proper use of modifiers. Understanding what is CPT code 97110, how it applies to different treatment scenarios, and the best practices around its use can make a substantial difference in compliance and revenue.

By integrating smart systems like PtEverywhere, practice owners and therapists can confidently manage 97110 billing with less hassle and greater efficiency. Make the most of your expertise and let the software handle the rest.

Want to simplify your 97110 billing? Explore PtEverywhere's features today and see how easy compliance can be.