Mastering CPT Code 97110 for Physical Therapy Practices

In the complex world of physical therapy billing, understanding and accurately applying CPT codes is essential for both clinical documentation and timely reimbursement. Among these, CPT Code 97110—used for therapeutic exercises—is one of the most frequently billed codes in outpatient rehabilitation settings. However, its frequent use also makes it a target for denials, audits, and compliance scrutiny.

At MediBill Health Partners, we’ve seen how mastering this single code can make a significant impact on revenue cycles for physical therapy practices. This blog will walk you through everything you need to know about CPT Code 97110—what it is, when to use it, how to document it properly, and how to avoid costly billing mistakes.

What is CPT Code 97110?

CPT 97110 is defined by the American Medical Association as:

“Therapeutic exercises to develop strength, endurance, range of motion, and flexibility (each 15 minutes, one-on-one with the patient).”

This code is used when a physical therapist performs and supervises active therapeutic exercises that are tailored to address the patient’s specific functional deficits. The key component here is direct one-on-one contact, which must be face-to-face and actively supervised.

Common Therapeutic Activities Billed Under 97110

Here are a few examples of treatments that fall under 97110:

• Resistance band or weight training for strength-building
• Stretching routines to increase flexibility or range of motion
• Cardiovascular activities (e.g., treadmill or stationary bike) to improve endurance
• Functional movement retraining
• Isometric or isotonic exercises for injury rehabilitation

The code can apply across various diagnoses, from post-operative rehabilitation and orthopedic conditions to neurologic disorders and chronic pain syndromes.

Key Documentation Requirements

Proper documentation is non-negotiable when it comes to billing 97110. Failure to provide clear, detailed notes is one of the top reasons payers deny reimbursement for this code.

To meet payer expectations, your documentation should include:

• Clear goals for the exercises performed (e.g., “Improve right shoulder flexion by 20 degrees”)
• Specific types of exercises used (e.g., “Theraband shoulder flexion against resistance”)
• Duration of each exercise and total time spent (minimum 8 minutes to bill one unit)
• Response to treatment or any patient progress during the session
• Confirmation of one-on-one direct contact

⚠️ Note: “Therapeutic exercise performed in a group setting or without direct therapist supervision does not qualify under 97110.*

Units and Time-Based Billing Guidelines

CPT 97110 follows the Medicare 8-Minute Rule, meaning that one unit can be billed if the therapist provides at least 8 minutes of direct treatment. Here’s a quick reference guide:

It’s crucial to track time spent on each individual timed code separately, especially when multiple codes (like 97140 or 97530) are used in a session.

Common Mistakes to Avoid

Despite being widely used, 97110 is one of the most frequently denied CPT codes. Here are some red flags that can lead to rejections:

• Lack of documentation showing progress: Payers want evidence that therapy is working.
• Using 97110 for passive modalities: This code is strictly for active therapeutic exercise.
• Missing time logs: Not tracking or documenting minutes correctly can lead to downcoding or denials.
• Duplicate services: Billing 97110 along with other codes like 97530 without clear justification of distinct services.

Medicare and Commercial Payer Considerations

While Medicare sets the standard with its 8-minute rule and focus on medical necessity, commercial payers can have varying requirements. Some might require pre-authorization, progress reports, or more detailed documentation. That’s why it’s essential to verify payer-specific policies before rendering services.

At MediBill Health Partners, we help physical therapy practices stay compliant by keeping tabs on ever-changing payer rules and ensuring correct coding from day one.

Best Practices for Clean Claims with 97110

To optimize reimbursement and minimize denials, here are some proven strategies:

• Use detailed templates in your EMR that prompt for time, goals, and patient response
• Perform regular internal audits to catch documentation gaps before claims go out
• Educate your therapy staff about coding and documentation standards
• Avoid copy-paste notes—they’re a red flag for payers and auditors
• Keep progress measurable and patient-specific

How MediBill Health Partners Can Help

Navigating the billing maze for physical therapy services—especially high-volume codes like 97110—requires precision, experience, and proactive management. That’s where MediBill Health Partners comes in.

We specialize in physical therapy billing and AR recovery, helping practices like yours:

• Ensure accurate CPT code usage
• Maximize reimbursement through clean claim submissions
• Stay audit-ready with detailed documentation reviews
• Reduce denials and accelerate cash flow
• Focus more on patient care and less on paperwork

Whether you’re a solo practitioner or a multi-location rehab center, our team is equipped to streamline your revenue cycle and support your long-term growth.

Final Thoughts

CPT Code 97110 is more than just a billing number—it’s a critical tool in the rehabilitation journey of countless patients. By mastering its correct usage and ensuring airtight documentation, physical therapy practices can boost both clinical impact and financial performance.

At MediBill Health Partners, we’re committed to making that process seamless. Reach out today for a free consultation, and let us show you how much more efficient and profitable your billing can be.