Billing and Coding: Home Health Physical Therapy

Home health physical therapy billing requires documentation of functional impairments and medical necessity; CPT 97110 is appropriate for cardiopulmonary exercise tolerance impairments and CPT 97542 for wheelchair propulsion training when tied to attainable functional goals. Specific CPTs (e.g., 97010/97018/97022/97026) require medical-necessity documentation available to the MAC, time must be reported in 15-minute increments using G0151, and several codes are excluded or restricted from use in certain contexts (e.g., 95851/95852/97750 not with initial evaluation; 97140 excludes home manipulation).

"CPT 97110 may be billed when treating impairments of exercise tolerance due to cardiopulmonary impairments."

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