CPT 97162 reports a moderate-complexity physical therapy evaluation, typically about 30 minutes, with an evolving history and three or more personal factors.
When to use 97162
Use 97162 for an initial PT evaluation of moderate complexity. Low- and high-complexity initial evaluations use 97161 and 97163, and re-evaluation uses 97164.
How to bill it
Select 97162 for a moderate-complexity initial PT eval with an evolving history and three or more personal factors; report one unit per evaluation.
Common pitfalls
- Defaulting to the middle code regardless of clinical complexity.
- Billing 97162 when the case actually met high-complexity criteria (97163).
Frequently asked questions
How is 97162 different from 97161?
97162 reflects moderate complexity with an evolving history and more personal factors; 97161 is low complexity with a stable history.
How long is a 97162 evaluation?
A moderate-complexity PT eval is typically about 30 minutes, but complexity drives code selection.