I am receiving many questions regarding what is the proper billing when a patient is referred to either outpatient physical therapy or occupational therapy for the purpose of an orthosis. In this article, I will answer this question from 2 perspectives. I will first address when a patient is referred for a one-time visit for an orthosis and secondly, provide the answer for when a full evaluation is required to develop the appropriate treatment plan in addition to an assessment related to determining the specific orthosis required for the patient.
First, we need to provide the CPT code and description for the 2 orthotic management and training CPT codes. Per the American Medical Association (AMA), CPT Professional Edition, 2021, CPT code
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