Concerns have been raised regarding the delivery of outpatient physical therapy services, specifically regarding the appropriate use of one-on-one codes as opposed to the group code. This page provides APTA's interpretation of the one-on-one and group codes. In addition, it includes patient care scenarios and APTA's analysis of the proper coding of those scenarios. Although these scenarios have been submitted to CMS, APTA has received no response from the agency as to its agreement or disagreement with APTA's interpretations. This page should not be construed as legal advice. The contents are intended for general informational purposes only, and readers are urged to consult their own legal counsel with regard to their own specific circumstances.
By using this site, you are consenting to our use of cookies. To find out more visit our privacy policy.
Share This
You Might Also Like...
Article
APTA Presses for Inclusion of CPT Codes in UHC Prior Authorization Reforms
Following UnitedHealthcare's Sept. 1 announcement eliminating 30% of prior authorization requirements for many of its plans, APTA reviewed the policy and
Article
Resources Offer a Practical Look at How PT Codes Are Valued
APTA has recently released two new payment resources to support the association's strategic priority of advancing payment for physical therapist
News
APTA Advocacy Win: Anthem Changes Payment Policy to Document Total Time per CodeAfter advocacy efforts from APTA staff and members, Anthem has changed its reimbursement policy so that PTs are no longer required to document start and