Billing for tele-physical therapy
Discover best practices for virtual PT reimbursement.
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As you prepare to launch your tele-PT program or improve your existing practice, take time to fully understand your billing options. You may need to consider additional training so your office is ready to seamlessly handle telehealth billing.
Get more information on billing for direct-to-consumer telehealth.
Medicare billing guidance
During the COVID-19 public health emergency, Medicare pays for real-time face-to-face telehealth furnished by physical therapy providers and physical therapy assistants under Medicare Part B.
Coding guidance is subject to change. Please refer to the complete list of telehealth services covered by Medicare from the Centers for Medicare & Medicaid Services.
Please note that there are no “telehealth-specific” CPT codes for physical therapy. The following codes are eligible to be used for reimbursement of tele-PT services.
| Category | Telehealth-eligible CPT codes |
|---|---|
|
Physical therapy evaluations |
97161, 97162, 97163, 97164 |
|
Therapy procedure using exercise |
97110 |
|
Neuromuscular reeducation |
97112 |
|
Therapeutic procedures |
97116 |
|
Therapeutic activities |
97530 |
|
Self-care/home management training |
97535 |
|
Wheelchair management |
97542 |
|
Functional capacity evaluation |
97750 |
|
Assistive technology assessment |
97755 |
|
Orthotic training |
97760 |
|
Orthotic, prosthetic training |
97761 |
More resources
Medicare Coverage and Payment of Virtual Services (video) — from the Centers for Medicare & Medicaid Services
Current State Laws & Reimbursement Policies — from the National Policy Center - Center for Connected Health Policy
Medicaid billing guidance
Medicaid does provide telehealth reimbursement, but not in all states.
Check the policy issued by your state Medicaid agency to confirm whether or not your state’s program currently reimburses for telehealth for PT services. Medicaid policies on the originating site and real-time vs asynchronous services also differ among states, so check each state and managed care organization’s policy.