Billing and Coding: Outpatient Physical and Occupational Therapy Services 2025

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Original Medicare covers outpatient therapy at 80% of the Medicare-approved amount. When you receive services from a participating provider, you pay a 20% coinsurance after you meet your Part B deductible ($257 in 2025).
Common ICD-10 codes for occupational therapy CodeShort Descriptor F82. Specific developmental disorder of motor function R62.50 Unspecified lack of expected normal physiological development in childhood M62.81 Muscle weakness (generalized) M25.511 Pain in right shoulder6 more rows
97530. Therapeutic activities, direct (one-on-one) patient. 97535. Self-care/home management training (e.g., 97537. Community/work reintegration training (e.g., 97545. Work hardening/conditioning; initial 2 hours. 97552. Caregiver training in strategies and techniques to. G0541. G0543. 97597.
Top 10 CPT Codes Billed for Occupational Therapists in 2021 CodeShort Descriptor 97110 Therapeutic exercises 97140 Manual therapy 97112 Neuromuscular re-education 97535 Self-care or home-management training6 more rows
Medicare Part A Co-Treatment Rules If, during a single treatment session, a patient receives therapy from two different practitioners working in two different disciplines (e.g., PT and OT), both therapists can bill for the entire treatment session separately.
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Replacement CPT Codes for 97001 97161Physical therapy evaluation: low complexity 97162 Physical therapy evaluation: moderate complexity 97163 Physical therapy evaluation: high complexity

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