We are going to discuss the list of frequently used CPT and HCPCS codes to report skilled services. Not all codes are accepted by all payers. Always review state rules, consult the CPT manual, and confirm payment policies with insurers prior to billing.
These codes are effective as of January 1, 2026.
Take a look at the following list of occupational therapy CPT codes to ensure accurate billing, maximize reimbursement potential, and contribute to your practice’s financial stability.
Occupational Therapy Billing Codes 2026
Here are the most commonly used CPT codes in occupational therapy practices, including codes for evaluation, modalities, therapeutic procedures, tests, remote therapeutic monitoring, and more.
Physical Medicine and Rehabilitation
Occupational therapy evaluations include an occupational profile, medical and therapy history, relevant assessments, and development of a plan of care, which reflects the therapist’s clinical reasoning and interpretation of the data.
| 97165 | Occupational therapy evaluation, low complexity |
| 97166 | Occupational therapy evaluation, moderate complexity |
| 97167 | Occupational therapy evaluation, high complexity |
| 97168 | Occupational therapy re-evaluation |
( 97168 for performance of a re-evaluation that is based on an established and ongoing plan of care). Refer to the CPT coding book for guidance on selecting and documenting the appropriate complexity level.
Modalities
Application of modality does not require (one-on-one) patient contact.
| 97010 | Application of a modality to one or more areas: hot or cold packs |
| 97018 | Paraffin bath |
| 97022 | whirlpool |
| 97024 | Diathermy (e.g., microwave) |
| G0281 | Electrical stimulation for wound care |
| G0283 | Electrical stimulation ( unattended), to 1 or more areas for indication(s) other than wound care, as part of a therapy plan of care |
| G0329 | This code is used for electromagnetic therapy for those chronic ulcers like pressure ulcers, arterial ulcers, diabetetic ulcers and venous stasis in which there are no clear signs that these diseases will not be cured after 30 days of normal treatment. |
| 97035 | Ultrasound, every 15 minutes |
Constant Attendance: Application of modality requires direct (one-on-one) patient contact.
Therapeutic Procedures
A manner of effecting change through the application of clinical skills and /or services that attempt to improve function.
| 97110 | Therapeutic procedures, one or more areas, every 15 minutes: therapeutic exercises to develop strength and endurance, range of motion, and flexibility |
| 97112 | Neuromuscular reduction of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities |
| 97113 | Aquatic therapy with therapeutic exercises |
| 97116 | Gait training includes stair climbing |
| 97124 | massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion) (Note: For myofascial release, use 97140) |
| 97129 | If a therapist gives one-on-onecognitive therapy to patient for 15 minutes in which they give them training on how to manage and align their work and steps to memoroze their things. |
| ✚97130 | ✚97130 each additional 15 minutes (List separately in addition to primary procedure) (Use in conjunction with 97129) |
| 97140 | Manual therapy techniques (e.g., mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes |
| 97150 | Therapeutic procedure(s), group (2 or more), untimed (Report for each member of the group) (Group therapy procedures involve constant attendance by the therapy practitioner but do not require one-on- one patient contact) |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes |
| 97533 | Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes |
| 97535 | Self-care/home management training (e.g., activities of daily living [ADLs] and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment), direct one-on-one contact, each 15 minutes |
| 97537 | Community/work reintegration training (e.g., shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes |
| 97542 | Wheelchair management (e.g., assessment, fitting, training), each 15 minutes |
| 97545 | Work hardening/conditioning; initial 2 hours |
| ✚97546 | Each additional hour (List separately in addition to primary procedure) (Use in conjunction with 97545) |
| 97550 | 97550 is used for face-to-face training of a caregiver to help the patient with daily activities, mobility, communication, feeding, and safety, without the patient present, for the initial 30 minutes. |
| ✚97551 | Each additional 15 minutes (List separately in addition to primary service) (Use in conjunction with 97550) |
| 97552 | This code is used when a healthcare provider gives face-to-face training to group of caregivers but the patient is not present at that time. This training helps caregivers support the patient with daily activities like doing work, walking, mobility or any other work. |
| G0541 | This code is used when the healthcare provider is giving training to patient caregiver or family member but patient is not present there at that time. This code is used for first 30 minutes training when provider and caregiver are sitting infront of eachother. |
| ✚G0542 | Each additional 15 minutes (list separately in addition to primary service) (Use in conjunction with G0541) |
| G0543 | Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to prevent decubitus ulcer formation, wound care, and infection control) (without the patient present), face-to-face with multiple sets of caregivers, untimed |
How to Calculate Occupational Therapy Billing Units:
It is very important to understand the occupational therapy billing units. Many occupational therapy billing unites are repported in under 15-minutes, but the number of units billed does not always equal the total treatment time divided by 15.
For Medicare Part B outpatient therapy services, providers generally follow the 8-minute rule when calculating units for timed CPT codes. Under this rule, at least 8 minutes of a timed service are generally required before one unit can be billed.
OT Billing Units Chart
The following chart shows how total timed treatment minutes translate into billable units:
| Total Timed Treatment Minutes | Billable Units |
| Less than 8 minutes | 0 units |
| 8–22 minutes | 1 unit |
| 23–37 minutes | 2 units |
| 38–52 minutes | 3 units |
| 53–67 minutes | 4 units |
| 68–82 minutes | 5 units |
| 83–97 minutes | 6 units |
| 98–112 minutes | 7 units |
| 113–127 minutes | 8 units |
The same pattern continues for treatment times exceeding 127 minutes.
How the 8-Minute Rule Works for Occupational Therapy
8-minute rule is applied to those CPT Codes that are billed in 15-minutes. For determining the umber of units the provider first calculate the total minutes spent on all timed services provided on same date of service
For example, if an occupational therapist provides a total of 40 minutes of timed treatment, the appropriate billing is 3 units, based on the total timed treatment minutes.
However, when multiple timed CPT codes are provided during the same session, the total number of billable units must also be allocated to the appropriate CPT codes based on the time spent on each service.
Example of Occupational Therapy Billing Units
If a patient on same day:
- Physical therapy = 10 minutes
- Therapeutic excercise = 15 minutes
10+15 = 25 minutes
According to 8-minute rule provider will calculate billable units on the basis of 25 minutes.
Timed vs. Untimed OT CPT Codes
Not every occupational therapy CPT code is billed in 15-minute units.
Timed codes are reported based on the amount of direct treatment time provided. Examples include:
- 97110 – Therapeutic exercises
- 97112 – Neuromuscular reeducation
- 97140 – Manual therapy techniques
- 97530 – Therapeutic activities
- 97535 – Self-care or home management training
Untimed codes are generally billed as a single unit regardless of the total time spent performing the service, subject to the applicable CPT code description and payer requirements.
When both timed and untimed services are provided on the same date, the time associated with untimed services should not be included when calculating the number of units for timed services.
Important Considerations for OT Billing Units
When you are billing occupational therapy services you must have to mention accurate documentation of treatment time. The total number of units reported on the claim must support the total number of timed treatment minutes.
You Must know that Medicare billing rules may not apply to commercial payers in exactly same way. Majority insurance companies uses different methods or they have their own limitations and requirements. Always verify applicable payer policy forst before submitting the claim.
If you have done proper collection of occupational therapy billing units, it can help in reducing errors and prevent overbilling and underbilling and support accurate reimbursement.
Reference
- CMS Therapy Services Guidance
- CMS: Billing and Coding for Outpatient Physical and Occupational Therapy Services
Active Wound Care Management
| 97597 | This code is used for the debridement and treatment of an open wound, covering a total wound surface area of first 20 sq. cm or less per session. |
| ✚97598 | 97598 is a CPT Code that is used for the selective debridement of open wounds (such as removing dead tissue or debris with a scalpel or waterjet) for each additional 20 square centimeters beyond the initial 20 square centimeters covered by the primary code 97597 |
| 97602 | This code is used for non-selective removal of dead tissue from a wound without anesthesia, including wound assessment, topical treatment, and ongoing care instructions per sessions. |
| 97610 | Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day |
TEST AND MEASUREMENTS
97750 is used for physical performance testing or measurement, including functional or musculoskeletal assesment with a written report billed for each 15 minutes.
97755 is used to access assistive technolog that helps improve a patient’s function independence and ability toperform daily activities with a written report billed in 15-minute increments.
ORTHOTIC MANAGEMENT AND TRAINING AND PROSTHETIC MANAGEMENT
97760: 97760 is used for the initial assessment, fitting, management and training of orthotic devices for the upper extremities, lower extremities or truck, billed in 15-minutes increments.
97761: Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes
97763: Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes
SPECIAL OTORHINOLARYNGOLOGIC SERVICES
92526:
Treatment of swallowing dysfunction and/or oral function for feeding
EVALUATIVE AND THERAPEUTIC SERVICES
92605:
Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient, first hour
✚92618:
Each additional 30 minutes (List separately in addition to primary procedure) (Use in conjunction with 92605)
92606:
Therapeutic service(s) for the use of non-speech-generating device, including programming and modification
92610:
Evaluation of oral and pharyngeal swallowing function
92611:
Motion fluoroscopic evaluation of swallowing function by cine or video recording
NEUROLOGY AND NEUROMUSCULAR PROCEDURES
MUSCLE AND RANGE OF MOTION TESTING
95851:
Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine).
95852:
hand, with or without comparison with normal side
OTHER PROCEDURES
95992:
Canalith repositioning procedure(s) (e.g., Epley maneuver, Semont maneuver), per day
CENTRAL NERVOUS SYSTEM ASSESSMENT/TESTS
96110;
Developmental screening (e.g., developmental milestone survey, speech and language delay screen) with scoring and documentation, per standardized instrument
96112:
This code is used when a qualified healthcare professional perform the development test of a patient ( especially toddlers ) that the development of a child is proper or not.
Things that are checked in this test:
- Fine aur gross motor skills
- Language
- Cognitive skills
- Social Skills
- Memory or executive functions
After that doctor interpret the test and also provide the report.
✚96113:
Each additional 30 minutes (List separately in addition to primary procedure) (Use in conjunction with 96112)
96125:
This code is used for the standardized testing of patients cognitive abilities, such as memory,thinking, information processing and problem solving. This codes includes the time spent on administering the test, interpreting the result and preparing the report and it is billed per hour.
96127:
It is used for a brief standardized assessment of a patient’s emotional or behavioral health, including scoring and documentation, for each assessment tool used.
HEALTH AND BEHAVIOR ASSESSMENT AND INTERVENTION
96156:
Health behavior assessment, or re-assessment (i.e., health-focused clinical interview, behavioral observation, clinical decision-making).
96158:
Health behavior intervention, individual, face-to-face; initial 30 minutes
✚96159:
Each additional 15 minutes (List separately in addition to primary procedure) (use in conjunction with 96158)
96161:
Administration of a caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument
96164:
Health behavior intervention, group (2 or more patients) face-to-face; initial 30 minutes
✚96165:
This code is used for a face-to-face health behavior intervention with the patient and their family present covering the initial 30 minutes.
✚96168:
Each additional 15 minutes (List separately in addition to primary procedure) (use in conjunction with 96167) 96170 Health behavior intervention, family (without the patient present), face-to-face; initial 30 minutes
✚96171:
Each additional 15 minutes (List separately in addition to primary procedure) (use
Conclusion:
CPT codes are crucial to obtaining the full reimbursement we have rightfully earned for each encounter. Staying informed and up to date ensures your billing practices remain accurate, efficient, and compliant. Consider adopting specialized billing software built with Ots in mind to streamline your processes and minimize errors.
At RevenueES our goal is to help other therapists with engaging patient-centered activities and documentation!
