What Can Be Billed Together in the Same 15-Minute Time Period
There is a myth that exists that you can’t bill 2 CPT codes during the same 15-minute time period. Well, that myth is only partially true. It is possible to bill 2 CPT codes during the same 15-minute time period. What you can’t do is bill two 15-minute time based CPT codes during the same 15-minute time period or bill an evaluation or reevaluation CPT code with any other timed or untimed CPT codes, including constant attendance modalities (CPT codes 97032 – 97039), therapeutic procedures (CPT codes 97110-97542) and group therapy. Confused? Continue reading below to see how you can bill 2 CPT codes during the same 15-minute time period, but can’t bill two 15-minute time based CPT codes during the same the same 15-minute time period.
So how can a therapist or assistant bill 2 CPT codes during the same 15-minute time period? By billing
The content here is for members only log in here or sign up.
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
Can you bill 1 unit of unattended ES (97014/G0283) and one unit of ther ex (97110) if you set up ES/IFC from 8:00-8:06 turn it on to run for 20 min and then perform skilled AAROM/AROM on an acute joint pain with edema from 8:07-8:20?
Yes! So how can a therapist or assistant bill 2 CPT codes during the same 15-minute time period? By billing a supervised, untimed, unattended modality code (CPT codes 97010 – 97028) with any other CPT code, timed or untimed, requiring constant attendance or direct one-on-one patient contact.
Likewise – one can bill two untimed codes concurrent to eachother (e.g. compression and estim for an ankle sprain) or untimed and timed concurrent to eachother (heat/ES to lumbar while attended manual therapy to shld)- correct?
A little clarification: “or bill an evaluation or reevaluation CPT code with any other timed or untimed CPT codes”
Can we not bill for evaluation and treatment in the same visit?
Can I evaluate for 30 minutes, perform 10 minutes of manual and bill 97001 and 97110?
You can’t bill an evaluation or re-evaluation during the same time period as any other CPT code. It’s not saying you can’t bill an evaluation or reevaluation on the same day as treatment.
I have an employer telling me that it’s okay to bill two timed codes in the same 15 minute increment for a Medicare patient and non Medicare patient (at the same time). It screams fraud to me. Their interpretation of guidelines notes that it is okay to do so as long as it is not two Medicare patients in that same 15 minute overlap.
If you are a Gold Member to my website, please log in and read the complete article for your answer.
What is the cost of membership to your company?
$159 per year of membership. Great value!
Can a therapist bill 2 units of G0283 when the e-stim is applied at the same time to 2 different body parts?
G0283 is a service-based (untimed) CPT code and can only be billed for 1 unit.
We are having therapist not wanting to bill Hot Pack concurrent with 97110×3 units. From this article, it is saying we can bill 97010 concurrent with 97110?
Correct! In addition, most insurance carriers do not reimburse for hot and cold packs.