CPT Code 97165: Occupational Therapy Evaluation, Low Complexity

Explore the CPT code 97165's usage, documentation, and billing requirements in our handy guide. Use it for low-complexity occupational therapy evaluations.

Use Code

Frequently asked questions

Yes, but only if there's a new episode of care or a significant change in the patient's clinical status requiring a fresh evaluation. Routine re-evaluations require different codes.

No, Current Procedural Terminology (CPT) code 97165 is not strictly time-based. However, CMS guidelines typically associate a low-complexity OT evaluation with about 30 minutes of face-to-face time.

Impairments in different areas of impairment may require different codes for occupational therapy. If three or more performance areas are identified or if clinical decision-making complexity increases, report CPT 97166 (moderate complexity) or 97167 (high complexity) accordingly.