Cpt Code 97110 Explained: Therapeutic Exercises For Physical Therapy Billing

By Author: Charlie Robinson
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If you’ve ever undergone physical therapy for conditions like back pain or a knee injury, you’ve likely been guided through specific exercises designed to aid recovery. These therapeutic exercises are billed using CPT Code 97110, making it one of the most frequently applied codes in physical therapy. However, billing for 97110 involves much more than simply adding it to a claim.
Since it is a time-based code, therapists must accurately track the minutes, document session details, and comply with payer-specific guidelines. Proper billing of CPT Code 97110 is crucial for preventing claim denials and ensuring appropriate reimbursement. For therapists, assistants, and billing teams, understanding the correct use of this code is essential for maintaining compliance and receiving timely payments.
This blog provides a complete overview of CPT Code 97110 and why it plays such a vital role in physical therapy billing.
What is CPT Code 97110?
CPT Code 97110 is a physical therapy billing code that represents therapeutic exercises delivered in a one-on-one session with a patient. These exercises aim to enhance ...
... strength, flexibility, range of motion, and overall functional ability. Because it is a time-based service, billing depends on the actual duration of direct interaction between the therapist and the patient.
Additionally, CPT 97110 is considered medically necessary when included in a prescribed treatment plan that is established and monitored by a licensed healthcare professional, such as a physical therapist or occupational therapist.
Who Can Bill for CPT 97110?
CPT Code 97110 can only be billed by licensed and qualified healthcare professionals. The following providers are authorized to report this code:
• Physical Therapists (PTs)
• Occupational Therapists (OTs)
• Physicians and Non-Physician Practitioners (when within their professional scope)
• Physical Therapist Assistants (PTAs) and Occupational Therapy Assistants (OTAs) – but only under direct supervision and in accordance with payer-specific guidelines
It is essential to follow state practice regulations and payer policies when billing for CPT 97110 . Unqualified personnel, including therapy aides, technicians, or support staff, are not permitted to bill for CPT 97110.
When to Use CPT 97110
This code should only be used for medically necessary therapeutic exercises that are part of a patient’s prescribed treatment plan, not for general fitness or wellness activities. Common clinical scenarios include:
• Strength Training – targeted exercises to rebuild or improve muscle strength during recovery
• Range of Motion Enhancement – exercises designed to increase joint mobility and flexibility
• Endurance Building – activities aimed at improving stamina and physical tolerance
• Balance and Coordination Training – exercises to restore control of movement after illness, surgery, or injury
• Prescribed Plan of Care – the exercises must be ordered, documented, and monitored by a licensed provider
• Individualized Supervised Sessions – applicable only when the therapist provides one-on-one therapy directly to the patient
In summary, CPT 97110 is intended for restoring functional abilities through structured, professionally supervised exercises as part of an established care plan.
Time-Based Billing
Time-based billing is designed to ensure therapists are compensated fairly for the actual time spent delivering skilled therapeutic services. To maintain consistency across payers, the 8-minute rule provides standardized guidelines for billing units.
Key Points:
• 15-Minute Billing Units:
CPT 97110 is reported in 15-minute increments. Rather than applying one code for the entire session, the therapist divides the time into standardized blocks, ensuring the claim reflects the precise therapy provided.
• Requirement of Direct Supervision:
The therapist must be physically present and directly engaged with the patient for the time to be billable. Time spent by the patient exercising independently, without direct oversight, cannot be claimed under this code.
• The 8-Minute Rule:
Medicare and most payers apply the 8-minute rule, which allows one billable unit if at least 8 minutes of direct therapeutic exercise are performed. Any duration under 8 minutes is non-billable.
• Billing for Multiple Units:
When therapy extends beyond one unit, additional units can be billed. For example, 23–37 minutes qualifies for two units. This structure ensures longer sessions are accurately represented in billing.
• Precise Documentation:
Therapists must carefully record the exact time spent providing direct treatment. Accurate documentation not only ensures compliance with payer regulations but also helps reduce claim denials.
Documentation Essentials
Accurate documentation is a critical aspect of billing CPT 97110. Clear and thorough records not only support reimbursement but also establish medical necessity, making claim approvals smoother and enabling providers to monitor patient progress effectively. Key elements include:
• Treatment Rationale
Records should clearly state the clinical reason for prescribing therapeutic exercises, directly linking them to the patient’s diagnosis, functional deficits, and goals outlined in the care plan.
• Exercise Details
Therapists must specify the exercises performed, the method of execution, and the body areas addressed. This information validates that therapy is aimed at improving recovery and functionality.
• Time Documentation
Since CPT 97110 is billed by time, it is essential to document the exact duration of one-on-one treatment. Accurate tracking ensures the correct number of units are billed and minimizes the chance of claim rejections.
• Patient Progress
Notes should capture the patient’s response to therapy—whether showing improvement, facing challenges, or experiencing setbacks. This reflects the effectiveness of the treatment plan and guides necessary adjustments.
• Therapist’s Authentication
Each entry must include the therapist’s full name, signature, and date. This ensures accountability, professional validity, and compliance with payer requirements.
Billing Modifiers
Billing modifiers are two-digit codes added to CPT claims to give insurers additional details. They clarify special situations and help ensure proper reimbursement for services billed under CPT 97110.
• Modifier 59
Indicates that therapeutic exercise (97110) was provided as a separate and distinct service from other procedures on the same day. It prevents claims from being combined.
• Modifier 76
Used when the same provider repeats the therapeutic exercise service on the same day, showing that the repetition was medically necessary.
• Modifier 77
Applied when the same therapeutic exercise is repeated by a different provider on the same day, ensuring clarity in payer records for proper claim processing.
• Modifier KX
Added when therapy services go beyond Medicare’s annual threshold. By using this modifier, the provider affirms that further treatment is medically necessary.
• Modifier GP/GO
These modifiers identify the type of care plan: GP for physical therapy and GO for occupational therapy. They are often mandatory for Medicare claims.
Reimbursement Details
Medicare typically reimburses CPT 97110 between $30 and $40 per unit, while private insurers may pay slightly higher—generally around $35 to $50 per unit. Actual payment can vary depending on region, provider type, and payer policies. Since rates are not universal, providers should always confirm reimbursement amounts directly with the payer before billing.
Conclusion
Though CPT Code 97110 appears simple, even minor errors in documentation, time tracking, or modifier usage can result in claim denials and delayed payments—creating unnecessary stress for therapy practices. With accurate coding knowledge and the right processes, providers can bill this code reliably.
For added ease, Outsourcing physical therapy billing and coding services to 24/7 Medical Billing Services ensures claims are managed correctly, denials are reduced, and reimbursement is maximized. Their expert team stays current with payer requirements, allowing practices to focus on patient care rather than billing complexities.

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