Use new PT, OT codes when billing BCN for physical and occupational therapy
On Jan. 1, 2017, new procedure codes went into effect for physical and occupational therapy evaluations for BCN HMOSM (commercial) and BCN AdvantageSM members. The new codes are indicated in bold below.
- Physical therapy (physical therapists):
- Service 1: *97110 for treatment
- Service 2: *97161, *97162 or *97163 for evaluation (These codes cannot be used by chiropractors.)
- Occupational therapy:
- Service 1: *97535 for treatment
- Service 2: *97165, *97166 or *97167 for evaluation
The document Procedures that require clinical review by eviCore healthcare has been updated with these codes.
*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
Posted: January 2017
Line of business: Blue Care Network