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97750 Time Requirement

  1. Lightbulb 97750 Time Requirement
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    I need feedback regarding the time requirement for 97750; CPT only states up to 15 minutes per unit with report, however there is no minimum time amount listed. Is there an industry standard for time that everyone uses to determine whether or not to bill this code?
    Scenario: Patient comes to physical therapy after being treated by physician for a work comp injury. Dr. orders a lifting test to determine if patient can perform their work functions. Patient goes to physical therapy suite and performs lifting test, only four minutes is spent performing the test. Normally if anything under half of 15 minutes 7.5 minutes is documented I do not bill the service; however cpt nor the few cpt assistants I've read give any minimum time requirement for this code. Any ideas?

  2. Default
    I generally use the 8 minute rule. If the treatment/procedure is less than 8 minutes and that is all that was performed I would bill the 97750-52 to reflect the reduced service.

  3. #3
    Phoenix, AZ
    It's not an industry standard to use the 8 minute rule. It's CMS guideline. Here's a link to the APTA article which includes the Transmittal for the 8 minute rule.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

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