CPT Code 97110: Therapeutic Exercises

What are therapeutic exercises?

Therapeutic exercises refer to a therapeutic procedure designed to improve a patient’s range of motion, muscle strength, endurance, balance, coordination, and overall functional performance. Described under 97110 CPT code, these exercises are a core component of physical therapy and occupational therapy programs, typically used to address muscle weakness, joint motion limitations, or to reeducate movement, balance, coordination kinesthetic sense.

They are integral to rehabilitation programs for patients recovering from orthopedic injuries, neurological conditions, postoperative procedures, or chronic impairments such as arthritis or chronic pain syndromes. Providers typically deliver therapeutic exercises individually, tailoring each session to a patient’s specific functional deficits and therapeutic goals.

CPT code 97110 documentation requirements

For CPT code 97110, thorough and proper documentation is critical to support the therapeutic procedure, demonstrate medical necessity, and ensure proper reimbursement. Inadequate records can lead to reimbursement claim denials, even if services were clinically appropriate. To stay compliant and maximize outcomes, documentation should include:

• Specific exercises performed: List all therapeutic exercises aimed to develop strength, endurance, range of motion, balance, coordination, kinesthetic sense, or improve cardio-pulmonary endurance.
• Body parts treated: Identify the precise joints or muscles addressed to show targeted functional performance improvements.
• Patient’s condition and deficits: Describe clinical findings such as muscle weakness, limited joint motion, or difficulty with functional tasks that justify the therapy.
• Treatment goals: State goals like restoring range of motion, increasing muscle strength, or enabling the patient to perform real-life movements or sport tasks.
• Time spent: Record that at least eight minutes were spent per billable unit of direct patient contact, in line with proper billing rules.
• Patient progress: Regularly document progress, showing how the exercise program advances the patient’s care and functional activities.
• Qualified healthcare professional involvement: Confirm that exercises were performed with direct contact from a physical therapist or other qualified healthcare professional.
• Distinguish from other services: If manual therapy techniques, therapeutic activities (97530 therapeutic activities), or neuromuscular reeducation are provided during the same session, document them separately to comply with proper coding.

Clear and accurate documentation is critical to validate continued medical necessity and to support reimbursement claims.

CPT code 97110 billing guidelines

Proper billing for CPT code 97110 ensures compliance, maximizes reimbursement, and supports continuity of patient care through therapeutic exercises. Key billing guidelines include:

• Follow the 8-minute rule: To bill one unit of therapeutic procedure under 97110 CPT code, at least eight minutes of direct contact performing specific exercises must be documented.
• Bill in 15-minute increments: Each unit of 97110 therapeutic exercise represents a 15-minute block focused on improving range of motion, muscle strength, balance, coordination, kinesthetic sense, or cardio pulmonary endurance.
• Separate from other procedures: Differentiate therapeutic exercises from other services like therapeutic activities (97530 therapeutic activities) or manual therapy techniques (97140) during the same session.
• Use modifier 59 when needed: If therapeutic exercises and other services are provided together, applying Modifier 59 ensures proper coding by indicating distinct services.
• Document specific exercises performed: List the functional activities (e.g., dynamic activities, motion exercises, use of upper extremity ergometer) to show the therapeutic intent and avoid reimbursement claim denials.
• Ensure direct patient contact: The qualified healthcare professional, such as a physical therapist, must maintain direct contact during exercises to meet billing standards.
• Confirm medical necessity: Link the therapeutic exercises to develop strength, improve functional performance, or assist in the reeducation of movement, balance coordination to the patient's clinical goals.

Proper documentation must reflect patient progress, body parts treated, and how the therapy supports the patient's treatment program or exercise program.

Other relevant CPT codes

• 97112: Neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and proprioception
• 97116: Gait training therapy
• 97530: Therapeutic activities, direct (one-on-one) patient contact, involving functional performance (e.g., lifting, bending, reaching)
• 97140: Manual therapy techniques (e.g., mobilization, manipulation, manual lymphatic drainage, manual traction)