Billing an Evaluation and CPT Code 97750 on the Same Day

May 13, 2019
Rick Gawenda

A question I often receive is can I bill and be paid for an evaluation or reevaluation (CPT codes 97161-97168) and a physical performance test and measurement (CPT code 97750) when provided on the same date of service by the same discipline? To obtain the answer, we must refer to the

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  1. Can 97750 ever be considered a stand alone code, meaning it is inclusive of the eval, test, and interpretation? Documentation would support the problem requiring the test, the specific standardized test performed, and include the provider’s interpretation.

    1. CPT code 97750 can’t replace a physical or occupational therapy evaluation. They are not the same.

  2. If a physician orders just a 6 Minute Walk Test and not a full therapy evaluation, can we just charge a 97750 without ever charging an Eval?

    1. From an insurance carrier perspective, I do not anticipate an issue. You would also need to check your state practice act to make sure that would be okay.