![]() ![]() However, patients using these products for home exercise programs under the supervision of a healthcare professional may be billed for the cost of the items. The products used to deliver the service in the clinic, such as elastic bands, are considered "bundled" in the fee for service and cannot be billed separately. Medicare and most other insurers do not reimburse for exercise equipment used by the patient at home. Remember that these codes are subject to the 'time' rule. Training for home exercises involving functional activities should use 97530. The time spent in educating the patient in a home exercise program for strengthening & stretching activities should be designated as therapeutic exercise, 97110. There is no specific CPT code for home exercise instruction. ![]() Home exercise programs are commonly prescribed in addition to in-clinic rehabilitation. Reimbursement for Self-Care Products at Home The therapist must be present, providing one-on-one contact with the patient, but does not have to be physically in the pool. Provide specific reasons that aquatic therapy is required, including the special properties of water. Document a timely plan for transition from water to land and integrate functional land components. Aquatic therapy should be differentiated from aquatic exercise as a skilled intervention by a licensed therapist to improve function. Patients should be appropriately selected for aquatic interventions. Aquatic therapy has suffered poor reimbursement because of confusion between therapy and exercise. **Aquatic therapy may require extra documentation. Therapeutic Activities utilize dynamic activities to improve functional performance these are also referred to as the "-ing" codes, for example, "lifting," "pulling," "pushing," "running," and "jumping." Therapeutic Exercise includes activities related to strengthening, endurance training, range of motion, and flexibility. *NOTE: Therapeutic exercise (97110) and therapeutic activities (97530) both require direct one-on-one provision of service according to Medicare guidelines. Includes effleurage, petrissage, and/or tapotementĪpplication of paraffin bath to one or more areasĮducation and Training for Patient Self-ManagementĮducation and training performed by a non-physician using a standardized curriculum Therapeutic Massage, one or more areas, each 15 minutes. Mobilization/manipulation, manual lymphatic drainage, manual traction, and soft tissue mobilization Manual Therapy techniques, one or more regions, each 15 minutes. Use of dynamic activities to improve functional performance with direct contact by the provider. Therapeutic Activities, direct hands-on, each 15 minutes. Therapeutic exercises to develop strength and endurance, range of motion and flexibility for 2 or more individuals. Group Therapeutic Exercise (2 or more individuals). Neuromuscular re-education of movement, balance, coordination, kinesthetic sense, posture, and proprioception (such as stabilization or balance training)Īquatic Therapy, one or more areas, each 15 min.Īquatic therapy with therapeutic exercises. Neuromuscular Re-education, one or more areas, each 15 min. Therapeutic exercises to develop strength and endurance, range of motion and flexibility. Therapeutic exercise, one or more areas, each 15 min. ![]() These rates are generally limited to "usual, reasonable, and customary" charges. The Resource-Based Relative Value System (RBRVS)is used to determine the reimbursement rate for Medicare. Be aware that code "modifiers" may be required as well. Remember that coding is specific to the payor therefore, it is important to know which codes are applicable. "Local Codes" may also be used in your area, particularly with Workers Compensation. These include CPT codes for procedures, and HCPCS Level II codes for supplies. ![]()
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