CPT 97110Physical Therapy

Therapeutic exercises

CPT code 97110 covers therapeutic exercises performed during physical therapy sessions to improve strength, flexibility, range of motion, or endurance. This is the code used when a therapist guides a patient through specific exercises tailored to their condition.

Showing rates for

National Average

Base Medicare rate

$28.79

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.45

PE RVU (NF)

0.43

MP RVU

0.01

Total RVU

0.89

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Apply the 8-minute rule correctly: bill one unit of 97110 for 8-22 minutes, two units for 23-37 minutes, three units for 38-52 minutes
Impact: Underbilling by one unit costs $28.79 per session; across 40 patients weekly this equals $59,867 annual revenue loss
Document specific exercises, sets, reps, resistance levels, and patient response in each session note
Impact: Prevents 60-70% of medical necessity denials; vague documentation like 'therapeutic exercises performed' leads to recoupments averaging $500-2,000 per audit
Never bill 97110 for the same time period as 97530 (therapeutic activities) - these codes are time-based and mutually exclusive for concurrent minutes
Impact: Double-billing time periods triggers CERT audits and potential fraud investigations; recoupments average $15,000-50,000 when identified
Bill 97110 separately from evaluation codes (97161-97163) on the same day without modifier 25 - these are different services
Impact: No modifier needed preserves full reimbursement of both codes; unnecessary modifier use may trigger payer edits reducing payment
For Medicare, attach modifier CQ when a PTA delivers the service to ensure compliant billing
Impact: Missing CQ modifier when required may result in overpayment recoupment of 15% ($4.32 per unit) plus potential False Claims Act liability
Document skilled intervention: explain why professional skill is required and why the patient cannot perform exercises independently
Impact: Establishes medical necessity; lack of skilled distinction is the #1 reason for Medicare ADR denials, averaging 25-40% claim denial rate

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Frequently asked questions

How much does Medicare pay for CPT code 97110 in 2025?

Medicare pays $28.79 for CPT code 97110 in 2025 under the national average non-facility rate. The facility rate is also $28.79. Actual payment may vary slightly by geographic locality based on the GPCI adjustment factors for your area.

How many units of 97110 can you bill per session?

There is no absolute limit on units of 97110 per session, but you must follow the 8-minute rule and document medical necessity for each unit. Billing more than 4-5 units (32-45 minutes) in a single session may trigger payer review unless documentation clearly supports the extended treatment time and medical necessity.

What is the 8-minute rule for billing CPT 97110?

The 8-minute rule requires at least 8 minutes of direct therapeutic exercise to bill one unit of 97110. Bill 1 unit for 8-22 minutes, 2 units for 23-37 minutes, 3 units for 38-52 minutes, and so on. Always round to the nearest unit based on the midpoint: total minutes divided by 15, then round to the nearest whole number.

Can you bill 97110 and 97530 together?

Yes, you can bill 97110 (therapeutic exercises) and 97530 (therapeutic activities) in the same session, but they must be performed during separate, distinct time periods. You cannot count the same minutes toward both codes. Document the specific minutes for each intervention and ensure they address different aspects of the treatment plan.

What RVU value does CPT 97110 have in 2025?

CPT 97110 has a total RVU of 0.89 in 2025, consisting of 0.45 work RVU, 0.43 practice expense RVU (both facility and non-facility), and 0.01 malpractice RVU. These values are multiplied by the 2025 conversion factor of 32.3465 to determine Medicare payment rates.

Do you need a modifier 25 to bill an evaluation with 97110 on the same day?

No, modifier 25 is not required when billing therapy evaluation codes (97161-97163) with 97110 on the same day. These are distinct services that are separately billable without a modifier. Modifier 25 is used for E/M services with procedures, not therapy codes.

What documentation is required to bill CPT code 97110?

Documentation must include the specific exercises performed, objective parameters (sets, reps, resistance), total minutes spent, patient response, skilled intervention provided, and progress toward functional goals. Notes must demonstrate why professional skill is necessary and why the patient cannot perform these exercises independently as a home program.