Work Hardening CPT Codes: Must I Be One-on-One With the Patient

September 16, 2019
Rick Gawenda

A question I am often asked is must the therapist or assistant be one-on-one when providing work hardening or conditioning to a patient? There are 2 CPT codes that describe work hardening/conditioning used by physical and occupational therapists. The codes and descriptors are as follows:

CPT code 97545 – Work hardening/conditioning; initial 2 hours

CPT code 97546 – Work hardening/conditioning; each additional hour

Now lets answer the question “Do CPT codes 97545 and 97546 require direct one-on-one contact”? Although these codes appear under the 97110 – 97546 heading of Therapeutic Procedures, these services do

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  1. Rick,

    You state that these services do not require therapist one-on-one contact. The time the patient spent performing the work hardening or conditioning is the time that counts towards the billable time and not the time the therapist or assistant spent with the patient.
    So, if the therapist spends 30min 1:1 with the pt (ie, before the pt begins work hardening) performing therex, etc to progress the pt, assess the pt, etc, this time can be billed under the appropriate CPT code, correct?

    1. If the patient is there for work hardening, work hardening CPT codes would be the most appropriate to bill if that is what you are focused on.

  2. Would you bill 97545 for the 1st visit of work conditioning-when evaluating the patient to make the work conditioning program? Or would there be a more appropriate code like 97750?

  3. Is 120 minutes (i.e. 2 hours) the minimum amount of time required to bill the 97545 code? Or is it like other time based codes where it must reach the mid point (i.e. 60-61 minutes)?

      1. Thanks! And if conditioning is less than 60 minutes, then should a therapist bill typical (97110, 97530, etc) CPT codes?

        1. Not if you are really doing work conditioning/hardening. Those 2 codes do not require direct one-on-one contact while the other codes you mentioned do.