CPT 97161 reports a low-complexity physical therapy evaluation, typically about 20 minutes, with a stable history and one to two personal factors.
When to use 97161
Use 97161 for an initial PT evaluation of low complexity. Moderate- and high-complexity initial evaluations use 97162 and 97163, and re-evaluation uses 97164.
How to bill it
Select 97161 for a low-complexity initial PT eval with a stable history and one to two personal factors; report one unit per evaluation, not per timed increment.
Common pitfalls
- Choosing the eval code by time rather than clinical complexity factors.
- Billing an initial eval code for a routine return visit instead of a re-eval.
Frequently asked questions
How do I choose among 97161, 97162, and 97163?
Selection is based on the stability of the history and the number of personal factors, not on time alone. 97161 is low, 97162 moderate, and 97163 high complexity.
How long is a 97161 evaluation?
A low-complexity PT eval is typically about 20 minutes, though complexity—not time—drives code selection.