CPT 97168 reports an occupational therapy re-evaluation of an established plan of care, typically about 30 minutes, used when there is a significant change in clinical status.
When to use 97168
Use 97168 to re-evaluate an existing OT plan of care when the patient’s status has significantly changed. Initial evaluations use 97165–97167.
How to bill it
Report per re-evaluation, documenting the significant change that justifies a new assessment.
Common pitfalls
- Billing a re-eval (97168) for routine treatment without a significant change.
- Confusing OT re-evaluation with the PT re-evaluation (97164).
Frequently asked questions
When is 97168 appropriate?
Use 97168 when a significant change in clinical status warrants a new OT assessment of an established plan of care.
Can 97168 be billed each visit?
No. Re-evaluation is reserved for significant changes, not routine treatment visits.