AMA CPT® Assistant - 2017 Issue 8 (August)
Physical Therapy Evaluations (August 2017)
August 2017 pages 3-5 Physical Therapy Evaluations The Current Procedural Terminology (CPT®) 2017 code set includes significant revisions to the coding and descriptions for physical therapy evaluations and re-evaluation services in the Medicine/Physical Medicine and Rehabilitation (PM&R) subsection. New codes (97161-97163) that describe three levels of physical therapy evaluation and one additional code (97164) for re-evaluation were created. In addition, extensive guidelines were added. The codes that were previously used to report these services were deleted and replaced with these new codes. Previously published articles addressed occupational therapy and athletic training evaluation and re-evaluation codes, however, this...
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Article Overview
This article explains the 2017 CPT changes for physical therapy evaluation and re-evaluation services within the Medicine/Physical Medicine and Rehabilitation section. It is aimed at coders, billers, therapists, and compliance staff who need to understand the scope of the revised guidance, the related terminology, and the general documentation themes discussed in the article.
Why This Topic Matters
The article matters because it describes a significant CPT revision that replaced older physical therapy evaluation and re-evaluation reporting with a new framework. Understanding the article helps readers recognize what changed, how the guidance is organized, and where the service fits within broader rehabilitation coding.
Article Sections
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August 2017 pages 3-5
Introductory material identifying the publication span and overall subject area of the article.
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Physical Therapy Evaluations
Overview of the updated CPT framework for physical therapy evaluation and re-evaluation services, including the general scope of the revision and the types of guidance provided.
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Coding Tip
General reminders about terminology and reporting considerations related to physical medicine and rehabilitation services.
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Determining the Correct Level of Evaluation
Discussion of the broad factors used to distinguish the levels of physical therapy evaluation and the documentation themes associated with them.
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Coding Tip
General guidance on standardized tests, measures, and outcome tools used during evaluation and re-evaluation.
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Definitions
Reference definitions for evaluation-related terminology used in the article, including body regions, body systems, body structures, and personal factors.
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Coding Tip
Additional clarification about documenting examined structures and the extent of the evaluation.
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Coding Tip
General reminder that these evaluation and re-evaluation services are service-based and that time references are only descriptive guidance.
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Clinical Example (97161)
A clinical scenario paired with procedure discussion illustrating the first of the new physical therapy evaluation levels.
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Clinical Example (97162)
A clinical scenario paired with procedure discussion illustrating the second of the new physical therapy evaluation levels.
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Clinical Example (97163)
A clinical scenario paired with procedure discussion illustrating the third of the new physical therapy evaluation levels.
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Clinical Example (97164)
A clinical scenario paired with procedure discussion illustrating the physical therapy re-evaluation service.
What You Will Learn
- How the 2017 CPT update changed physical therapy evaluation and re-evaluation reporting
- What types of documentation themes are emphasized in the revised guidance
- How the article organizes the concepts used to distinguish evaluation levels
- What kinds of reference material and clinical examples are included for physical therapy services
Who Should Read This
- Medical coders
- Billing staff
- Physical therapists
- Rehabilitation compliance professionals
- Documentation reviewers
Codes Discussed
Code Ranges Discussed
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