New Evaluation Codes

NEW EVALUATION CODES

FOR PHYSICAL & OCCUPATIONAL THERAPISTS

TheraOffice Documentation

On January 1, 2017 Physical and Occupation Therapists will be required to submit new evaluation and re-evaluation codes. The original evaluation codes of 97001 and 97003 will now be divided based on the complexity of the evaluation. The re-evaluation codes of 97002 and 97004 will not be divided based on complexity, but the code will be updated. It is important for all therapists to be educated on this subject to ensure compliance.

Training Webinars

 

New Evaluation Codes

New Evaluation Codes

New Evaluation Codes

 

Tuesday, December 6th

Wednesday, December 14th

Tuesday, December 20th

 

12:00PM - 1:00PM CST

11:00AM - 12:00PM CST

1:00PM - 2:00PM CST

 

DETERMINING CODES:

Occupational Therapists:

Infographic_Chart_v3_OT-01

 

Physical Therapists:

Infographic_Chart_v2_Page_1

 

Frequently Asked Questions:

What is the new evaluation code change?

Currently, when a Physical or Occupational Therapist evaluates a patient, they bill for an evaluation code of either 97001 or 97003 depending on the discipline.  Beginning in 2017, each of these evaluation codes will be divided into three codes based on the complexity of the evaluation.

When does this go into effect?

These new CPT codes MUST be used for dates of service on or after January 1, 2017.  They CANNOT be used for dates of service prior to then.

Which payers are affected?

These new codes must be used for all HIPAA-covered insurances.  While this does not include workers’ compensation insurances, they will have the choice of which CPT codes they would like to use.  At this time, we believe they will adopt the new set of codes and be in line with all HIPAA-covered insurances, much like the ICD-10 transition.

Does this impact PT, OT, and SLP?

In 2017, the PT (97001) and OT (97003) evaluation codes are being divided based on severity.  SLP currently has multiple evaluation codes, so they will see no additional changes at this time.

Will my reimbursement change?

At this time, each level of severity will reimburse at the same rate.  This is something that may change once more data has been collected.

Will this webinar be recorded?

Yes, the webinar will be recorded and available in the Training Center.  You can access the Training Center from any of the TheraOffice Modules by going to Help>Training Center.