CPT 97161Physical TherapyUntimed · per session

PT evaluation — low complexity

What CPT 97161 covers

CPT 97161 is the low-complexity PT evaluation: no comorbidities affecting the plan, 1–2 elements of examination, stable clinical presentation, and low-complexity decision-making.

Using 97161 on superbills

Fits single-issue pediatric referrals (e.g., isolated toe-walking screen with no comorbid findings).
Choose the level your documented examination supports — not the one that pays more.

Documentation that supports it

History, examination elements addressed, and clinical decision-making rationale

Common ICD-10 pairings

Examples seen in pediatric practice — always code the diagnosis that fits the client.

R26.89M62.81

FAQ

Do the PT evaluation levels pay differently?

Medicare pays 97161–97163 at the same rate today; commercial payers vary. Your cash-pay fee can reflect the work involved — the superbill shows your actual charge.

97162PT evaluation — moderate complexity 97163PT evaluation — high complexity 97110Therapeutic exercises

Educational reference only — not billing, coding, or legal advice. CPT® is a registered trademark of the American Medical Association. Verify current code definitions and payer policies before billing.