Top 50 Physical Therapy CPT Codes & ICD-10 Codes Cheatsheet (2024)

Anyone who does medical coding on a regular basis knows the value of a cheat sheet. At SuperBill, our mission is to save you time and money. That’s why we’ve built a list of time-saving ICD-10 and CPT codes for physical therapy, or PT.

According to the American Physical Therapy Association, over 300 million physical therapy sessions happen each year. And the profession is expected to grow 17% by 2031. That’s A LOT of medical coding!

Save yourself some hassle by quickly scanning this list. For physical therapy CPT codes, skip to the bottom section. For physical therapy ICD-10 codes, just keep reading.

What Are Physical Therapy ICD-10 Codes?

The International Classification of Disease, 10th Revision (ICD-10) is a universal series of diagnosis codes physical therapists use to identify ailments. They are especially useful for billing, because they standardize the terms used by both medical providers and insurers. The full list of ICD-10 codes on CMS.gov is over 1,000 pages long. So, medical coders often refer to cheat sheets like this one to increase their efficiency with PT ICD-10 codes.

In 2015, the medical community, including physical therapists, transitioned from ICD-9 to ICD-10. Now, the newest revision of the International Classification of Diseases, ICD-11, is on its way. While it has been implemented in some countries, the U.S. hasn’t implemented ICD-11. There is no announced date for ICD-11 to take effect, so continue using ICD-10 codes until further notice. ICD-9, however, is out of date and will not be accepted by insurers.

Common ICD-10 Codes for Physical Therapy

Many common ICD-10 Codes for PT come from Section M of the ICD-10, “Diseases of the musculoskeletal system and connective tissue.” Search the following table for some of the most commonly used PT ICD-10 codes.

Code Name

Diagnosis Common Name

Additional Name(s)

Billable?

ICD-10 M25.511

Pain in right shoulder

N/A

Yes

ICD-10 M25.512

Pain in left shoulder

N/A

Yes

ICD-10 M25.551

Pain in right hip

N/A

Yes

ICD-10 M25.552

Pain in left hip

N/A

Yes

ICD-10 M25.561

Pain in right knee

N/A

Yes

ICD-10 M25.562

Pain in left knee

N/A

Yes

ICD-10 M53.3

Sacrococcygeal disorders,
not elsewhere classified

Coccygodynia

Yes

ICD-10 M54.5

Low back pain

Loin pain
Lumbago NOS

Yes

ICD-10 M54.6

Pain in thoracic spine

N/A

Yes

ICD-10 M54.89

Other dorsalgia

N/A

Yes

ICD-10 M54.9

Dorsalgia, unspecified

Backache NOS
Back pain NOS

Yes

ICD-10 M79.601

Pain in right arm

Pain in right upper limb NOS

Yes

ICD-10 M79.602

Pain in left arm

Pain in left upper limb NOS

Yes

ICD-10 M79.604

Pain in right leg

Pain in right lower leg NOS

Yes

ICD-10 M79.605

Pain in left leg

Pain in left lower limb NOS

Yes

ICD-10 M79.641

Pain in right hand

N/A

Yes

ICD-10 M79.642

Pain in left hand

N/A

Yes

ICD-10 M79.671

Pain in right foot

N/A

Yes

ICD-10 M79.672

Pain in left foot

N/A

Yes

ICD-10 S93.0R

Dislocation of right ankle

N/A

Yes

ICD-10 S93.0L

Dislocation of left ankle

N/A

Yes

ICD-10 S93.2R

Rupture of ligaments at right ankle/foot level

N/A

Yes

ICD-10 S93.2L

Rupture of ligaments at left ankle/foot level

N/A

Yes

ICD-10 S93.40R

Sprain and strain of right ankle: part unspecified

N/A

Yes

ICD-10 S93.40L

Sprain and strain of left ankle: part unspecified

N/A

Yes

ICD-10 S93.41R

Sprain and strain of right ankle: deltoid (ligament)

N/A

Yes

ICD-10 S93.41L

Sprain and strain of left ankle: deltoid (ligament)

N/A

Yes

ICD-10 S93.42R

Sprain and strain of right ankle: calcaneofibular (ligament)

N/A

Yes

ICD-10 S93.42L

Sprain and strain of left ankle: calcaneofibular (ligament

N/A

Yes

ICD-10 S93.43R

Sprain and strain of right ankle: tibiofibular (ligament), distal

N/A

Yes

ICD-10 S93.43L

Sprain and strain of left ankle: tibiofibular (ligament), distal

N/A

Yes

Is there a common physical therapy ICD-10 code that we left out? Let us know at support@thesuperbill.com and we’ll do our best to add it!

What are Physical Therapy CPT Codes?

Current Procedural Terminology (CPT) codes are similar to ICD codes in that they both give providers and insurers a uniform language for medical occurrences. However, the difference between CPT and ICD codes is that CPT codes describe medical services rendered. Where an ICD code identifies a diagnosis, a CPT code marks the procedure or prescription issued in response to a diagnosis.

For instance, suppose you treat a physical therapy patient with low back pain. The ICD-10 code for the low back pain diagnosis would be M54.5. If you administer a hot/cold pack for the pain, the CPT code for that treatment would be 97010. CPT codes are generally numeric (with a few exceptions) as opposed to the alphanumeric system of ICD codes.

How to Bill Time Units in PT CPT Codes

Note that many of these procedures are performed multiple times per session. To bill correctly, it’s essential that you understand time units and the 8-minute rule. The standard unit of time for the AMA is 15 minutes. That means that for billing purposes, an hour-long session of manual therapy techniques would have four 97140 codes. (Since each code denotes one 15-minute segment of time.)

Procedures marked N/A are considered “non-timed” services and should be billed per service unit. For instance, if you perform an ultrasound, you will mark code 97035 only one time, regardless of how long it takes.

Common CPT Codes for Physical Therapy

Lists of CPT codes are harder to find for free than ICD codes. Many websites charge you for their cheat sheets and code-finders. SuperBill’s list of PT CPT codes however, is completely free. Access physical therapy CPT codes—from evaluations to therapeutic exercises and massage therapy CPT codes—here at any time.

Code Name

Diagnosis Common Name

Duration (Min)

Billable?

92507

SLP Treatment; Individual

N/A

Yes

97010

Hot/Cold Packs

N/A

No
(bundle w/ primary service)

97012

Mechanical Traction

N/A

Yes

97014

Electrical Stimulation (Unattended)

N/A

Yes

97016

Vasopneumatic Device

N/A

Yes

97032

Electrical Stimulation (Manual)

15

Yes

97035

Ultrasound/Phonophoresis

N/A

Yes

97110

Therapeutic exercise

15

Yes

97112

Neuromuscular re-education

15

Yes

97113

Aquatic Therapy/Exercise

15

Yes

97116

Gait Training

15

Yes

97124

Massage Therapy

15

Yes

97140

Manual therapy techniques

15

Yes

97150

Group Therapy

N/A

Yes

97161

PT Evaluation: Low Complexity

N/A

Yes

97162

PT Evaluation: Moderate Complexity

N/A

Yes

97162

PT Evaluation: High Complexity

N/A

Yes

97164

PT Re-Evaluation

N/A

Yes

97530

Therapeutic Activities

15

Yes

97535

Self Care/Home Management Training

15

Yes

Further Reading

For more general medical coding advice, check out our post on CPT and ICD-10 Coding Tips. If you’re an out-of-network provider looking for an easier way to explain OON billing, take a look at How to Explain Superbills and OON Reimbursem*nt to Your Clients.

If your practice is spending hours on the phone with insurers, navigating tedious questions like these, you're wasting your time! SuperDial's state-of-the-art tech automates phone calls to insurers, freeing your staff up to do what they do best: provide quality care.

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Top 50 Physical Therapy CPT Codes & ICD-10 Codes Cheatsheet (2024)

FAQs

Where can I get a list of all CPT codes? ›

The Centers for Medicare & Medicaid Services offer a free search (CPT code lookup) for RVU for every CPT code. Users can also request a CPT/RVU Data File license from the AMA to easily import codes and descriptions into existing claims and medical billing systems.

What ICD-10 code is used for physical therapy? ›

Common ICD-10 Codes for Physical Therapy
Code NameDiagnosis Common NameBillable?
ICD-10 M54.5Low back painYes
ICD-10 M54.6Pain in thoracic spineYes
ICD-10 M54.89Other dorsalgiaYes
ICD-10 M54.9Dorsalgia, unspecifiedYes
27 more rows
Feb 15, 2024

What is the 8 minute rule? ›

The 8-minute rule was introduced into the rehab therapy billing process in the year 2000 and is utilized by outpatient physical therapy services, allowing a physical therapy practitioner to bill for services as long as they see their patient for at least eight minutes, which would serve as one unit of therapeutic ...

Can a PT treat two patients at the same time? ›

Typically, Physical Therapists (PT) work with two or more patients at the same time.

What is the difference between CPT code 97110 and 97530? ›

What is the difference between therapeutic exercise vs therapeutic activity? Therapeutic exercise is billed as 97110 and Therapeutic activity is billed as 97530. Both are CPT codes that are commonly used in occupational and physical therapy billing. These codes are very similar and are often confused.

What is the best CPT code website? ›

Codify by AAPC helps you quickly and accurately select the CPT® codes you need to keep your claims on track.

What is the difference between CPT codes and ICD codes? ›

While CPT codes are similar to ICD-10 codes, CPT codes identify services rendered, whereas ICD-10 codes represent patient diagnoses.

What CPT codes are deleted for 2024? ›

Codes 99441, 99442, and 99443 will be deleted. In 2024, revisions will be made to various sections of the CPT code set that contain unlisted service codes to reflect their appropriate use when reporting with other services.

Can physical therapist use Z codes? ›

However, if you're providing surgical aftercare, Z-codes are perfectly appropriate. For example, you could use Z51. 89, encounter for other specified aftercare, or Z47.

What is the ICD-10 code for poor mobility? ›

2024 ICD-10-CM Diagnosis Code Z74. 0: Reduced mobility.

What is the ICD-10 code for therapy? ›

90792 – Psychiatric Diagnostic Evaluation with medical services. 90832 – Psychotherapy, 30 minutes (16-37 minutes) 90834 – Psychotherapy, 45 minutes (38-52 minutes) 90837 – Psychotherapy, 60 minutes (53 minutes and over)

What is the 5-minute rule? ›

Using the 5-minute rule, you set a goal of doing whatever it is you would otherwise avoid, but you only do it for a set amount of time: five minutes. If, after five minutes, it's so horrible that you have to stop, you're free to do so.

Is 97110 a timed code? ›

CPT® code 97110: Therapy procedure using exercise to develop strength, endurance, range of motion and flexibility, each 15 minutes. As the authority on the CPT® code set, the AMA is providing the top-searched codes to help remove obstacles and burdens that interfere with patient care.

How many therapy units is 40 minutes? ›

UnitsNumber of Minutes
1≥ 8 minutes through 22 minutes
2≥ 23 minutes through 37 minutes
3≥ 38 minutes through 52 minutes
4≥ 53 minutes through 67 minutes
4 more rows
Jan 25, 2024

What is the difference between CPT 97110 and 97112? ›

Keep reading for a detailed summary of CPT 97110: Therapeutic Exercise, CPT 97112: Therapeutic Procedure (stroke and non-stroke), and 97530 Therapeutic Activities.

What is the CPT code for PT session? ›

A Note on CPT Code 97110

Perhaps the most common physical therapy CPT code seen is 97110—therapeutic exercises. This often denotes the bread and butter of what PTs do, especially with patients suffering from musculoskeletal dysfunctions.

What is CPT code 97150 for physical therapy? ›

CPT 97150 consists of all therapeutic services provided to a group of 2 or more people at the same time. These techniques may include water therapy, conditioning therapy, or exercise therapy with the constant presence of a doctor or licensed therapist, but not in individual contact with an individual patient.

What is the difference between 97530 and 97535? ›

CPT code 97530 (Therapeutic Exercise) primarily focuses on muscle and joint function restoration, while CPT code 97535 (Therapeutic Activities) includes interventions that target balance, coordination tasks, functional tasks, and other aspects of physical impairments and functional restrictions.

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