CPT 97163Physical TherapyUntimed · per session
PT evaluation — high complexity
What CPT 97163 covers
CPT 97163 is the high-complexity PT evaluation: 3+ comorbidities, 4+ examination elements, unstable/unpredictable presentation, and high-complexity decision-making.
Using 97163 on superbills
- Fits medically complex children — e.g., cerebral palsy with seizures and equipment needs.
Documentation that supports it
- Comprehensive history, multiple examination elements, and complex clinical reasoning
Common ICD-10 pairings
Examples seen in pediatric practice — always code the diagnosis that fits the client.
G80.0G80.9Q05.9G93.1
FAQ
When is high complexity justified in pediatrics?
When comorbidities genuinely change your examination and planning — multiple diagnoses, unstable presentation, equipment and caregiver factors — and your report demonstrates it.
Related codes
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.