Understanding the New Therapy Evaluation Codes

Presented by Rick Gawenda, PT

Beginning with dates of services on and after Jan. 1, 2017, CPT codes 97001 (Physical Therapy Evaluation), 97002 (Physical Therapy Reevaluation), 97003 (Occupational Therapy Evaluation), and 97004 (Occupational Therapy Reevaluation) will be deleted from the CPT book and will be replaced with three new evaluation CPT codes and one new reevaluation CPT code for physical therapy services, and three new evaluation CPT codes and one new reevaluation CPT code for occupational therapy services. The new CPT codes are not only applicable to the Medicare program, but all insurance carriers that are a HIPAA-covered entity. This would include state Medicaid programs, Aetna, Cigna, BCBS, Tricare, and UnitedHealthcare, just to name a few.

This 1.5-hour webinar will provide the new evaluation and reevaluation CPT codes, the long descriptor of the new CPT codes, and what components must be included in the evaluation in order for the evaluating therapist to report the correct CPT code. The webinar will also discuss the proposed work and practice expenses relative value unit (RVU) from CMS for the eight new codes and how the RVUs impact payment for each CPT code.

Objectives:

• List the new evaluation and reevaluation CPT codes.
• Describe the components that are required for each of the new evaluation and reevaluation CPT codes.
• Understand how the RVUs are used to determine payment for each of the new CPT codes.
• Recite what insurance carriers will use the new evaluation and reevaluation CPT codes.
• Determine how the new CPT codes will impact the annual therapy cap and MPPR.