Billing

Goodbye, 97001 & 97002

By Monica White, DPT, PRCP

As you may have heard, Centers for Medicaid & Medicare Services (CMS) is changing how we code for physical therapy evaluations in 2017. There will be three new evaluation codes– 97X61, 97X62, and 97X63–that will replace 97001, and one new re-evaluation code, 97X64, that will replace 97002.

How will this change the reimbursement rate?

At this point we’re not sure. CMS will publish the final ruling on payment rates in late October or early November. CMS has proposed to keep the same reimbursement rate whether you are evaluating a relatively simple or a complex patient or whether you spend 20 minutes or 45 minutes evaluating a patient. Check out what the new codes will look like below:

New Physical Therapy CPT Codes

 Change is just around the corner! Keep an eye on the SOWH Blog and the SOWH Payment, Policy, and Advocacy web page for more updates:  http://www.womenshealthapta.org/practice/payment-policy-and-advocacy/

AUTHOR: Monica White, DPT, PRCP, is a CAPP-Pelvic certified member of the SOWH Reimbursement Committee.

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