Next Event: 2026 CPT Coding and Billing for Speech Therapy Services
Date: January 20,2026
Billing Neuromuscular Reeducation for Pediatric Patients
In this article, I will answer the following questions regarding billing and payment of neuromuscular reeducation provided to pediatric patients:
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Hi Rick. Can 97112 (neuro re-ed) be used for ADULT MEDICARE patients even if they do not have a neuro diagnosis? For example, doing single leg stand balance exercises after a TKA.
Yes, unless a MAC has specific limitations on the reimbursement of 97112.
Do you know if the Texas MAC has a limitation of 97112?
You would need to check if they have a LCD for PT and OT and if so, do they say anything about 97112. All CPT codes have what they call a medically unlikely edit (MUE) that will tell you how many units of that code can be billed and paid on the same date of service.
Here is a link to an article that I wrote 3 years ago:
https://gawendaseminars.com/does-cms-limit-outpatient-therapy-units/