Skip to main content

CPT© (Current Procedural Terminology) coding is the means by which the vast majority of health care providers receive payment. Although physical therapists (PTs) frequently use CPT codes, they aren't necessarily familiar with the process by which the codes are developed, approved, adopted, valued, modified, and deleted. Understanding CPT codes, what they represent, and how precisely they do or do not translate into actual payment is an important aspect of physical therapist practice.

PT coding is not simply an administrative task. It represents the level and intensity of care provided by the PT. In their 2006 book Redefining Health Care, Michael E. Porter and Elizabeth Olmstead Teisberg defined value as outcomes over cost. With the American health care system moving toward value-based care and payment models, PTs must be able to provide objective information for both the numerator and denominator in Porter and Teisberg's equation.

If a PT does not understand coding—and thus does not ensure billing of the codes that most specifically and accurately represent the provided care—that PT risks inaccurate reimbursement, denials, recoupment of payments, and even investigation for fraud and abuse.

Log in or create a free account to keep reading.

Join APTA to get unlimited access to content.

You Might Also Like...


More APTA Members Will Serve on Key AMA Coding Committees

Nov 18, 2022

Two members have been named to advisory committees that shape codes and code values.


Coding Win: New Caregiver Education Codes Available to PTs in 2024

Nov 15, 2022

APTA, AOTA, and ASHA successfully made the case for codes that can be applied to caregiver education for patients with functional deficits.


Commercial Payer Update, August 2022

Aug 24, 2022

The PTA differential, MPPR, payment limits, and more.