Learn everything about CPT 97530, including its definition, usage, documentation requirements, and billing tips. Optimize claims with BillingCare Solutions.

What is CPT 97530?

CPT 97530 is a commonly used code in physical and occupational therapy, defined as:

Therapeutic Activities, direct (one-on-one) patient contact, each 15 minutes

This code is used when a therapist performs activities designed to improve functional performance, such as:

  • Range of motion

  • Strength

  • Coordination

  • Motor skills

CPT 97530 requires direct, one-on-one patient interaction and is billed in 15-minute increments.

When to Use CPT 97530

CPT 97530 is appropriate when a therapist provides skilled, individualized therapeutic activities that:

  • Address deficits from injury, illness, or surgery

  • Improve patient’s ability to perform daily activities

  • Are performed under direct supervision of a licensed therapist

Examples of CPT 97530 Activities:

  • Balance and coordination exercises

  • Functional reaching or lifting tasks

  • Therapeutic games to improve motor skills

  • Task-oriented functional activities

Documentation Requirements

Accurate documentation is crucial for CPT 97530 to support reimbursement. Documentation should include:

  1. Date and duration of therapy (in 15-minute increments)

  2. Patient’s functional deficits and therapy goals

  3. Specific therapeutic activities performed

  4. Patient response to treatment

  5. Therapist credentials and signature

Incomplete documentation can lead to claim denials or audits.

Billing and Coding Tips for CPT 97530

  • Bill per 15-minute unit; do not round up or down incorrectly.

  • Do not combine with group therapy codes unless separately provided.

  • Use modifier codes when required (e.g., for multiple procedures or same-day services).

  • Verify payer policies for coverage and reimbursement rates.

Common Mistakes to Avoid

  1. Billing 97530 for non-skilled activities (e.g., general exercises without therapeutic purpose)

  2. Omitting direct one-on-one patient interaction

  3. Failing to document functional outcomes or patient progress

  4. Incorrectly billing in time increments

Following proper coding guidelines reduces denials and ensures compliant billing.

Final Thoughts

CPT 97530 is essential for documenting and billing therapeutic activities in physical and occupational therapy. Proper coding, accurate documentation, and understanding payer requirements ensure correct reimbursement and compliance.

At Billing Care Solutions, we help healthcare providers navigate CPT coding, optimize billing, and reduce claim denials.