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Replacement CPT Codes for 97001 CPT CodeDescription97161Physical therapy evaluation: low complexity97162Physical therapy evaluation: moderate complexity97163Physical therapy evaluation: high complexity
Some insurance companies classify physical therapists as specialists. Certain plans require you to get a referral from your primary care provider before they will pay for any specialist's services. For example, your copay might be $20 to see your primary doctor and $30 for a specialist (such as a physical therapist).
A unit refers to the length of a treatment session. For timed units (like manual therapy), add together the total timed minutes on a specific date. Then, divide that number by 15 to determine how many units you can bill. If more than 8 minutes of total time are left, you can bill an additional unit.
Enter the 8-Minute Rule If eight or more minutes are left over, you can bill for one more unit; if seven or fewer minutes remain, you cannot bill an additional unit.