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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Michigan Medicaid Sample PT/OT Rates

Michigan Medicaid rates for physical and occupational therapy services.  These are the fee-for-service rates so they may be different from Medicaid managed care rates and rates may change based on the setting or patient category.  Members can ask questions or request information on any Medicaid issue at any time.  Please consider joining today if you need assistance.  

Physical Therapy Fees – Posted April 1, 2024

Code

Short Description

Private Practice Therapist

95851

Range Of Motion Measurements

$13.85

95852

Range Of Motion Measurements

$11.50

97012

Mechanical Traction Therapy

$8.95

97014

Electric Stimulation Therapy

$7.88

97016

Vasopneumatic Device Therapy

$7.46

97018

Paraffin Bath Therapy

$3.62

97022

Whirlpool Therapy

$10.86

97024

Diathermy Eg Microwave

$4.69

97026

Infrared Therapy

$4.26

97028

Ultraviolet Therapy

$5.33

97032

Appl Modality 1+Estim Ea 15

$9.16

97033

App Mdlty 1+Iontphrsis Ea 15

$12.35

97034

App Mdlty 1+Cntrst Bth Ea 15

$8.95

97035

App Mdlty 1+Ultrasound Ea 15

$8.95

97036

App Mdlty 1+Hubbrd Tnk Ea 15

$22.37

97039

Unlisted Modality

M

97110

Therapeutic Exercises

$18.74

97112

Neuromuscular Reeducation

$21.51

97116

Gait Training Therapy

$18.74

97124

Massage Therapy

$19.38

97129

Ther Ivntj 1st 15 Min

$14.27

97130

Ther Ivntj Ea Addl 15 Min

$13.63

97139

Unlisted Therapeutic Px

M

97140

Manual Therapy 1/> Regions

$17.25

97161

Pt Eval Low Complex 20 Min

$64.11

97162

Pt Eval Mod Complex 30 Min

$64.11

97163

Pt Eval High Complex 45 Min

$64.11

97164

Pt Re-Eval Est Plan Care

$44.52

97530

Therapeutic Activities

$23.43

97533

Sensory Integration

$39.83

97535

Self Care Mngment Training

$20.87

97542

Wheelchair Mngment Training

$20.24

97550

Caregiver Traing 1st 30 Min

$33.87

97551

Caregiver Traing Ea Addl 15

$16.83

97760

Orthotic Mgmt&Traing 1st Enc

$30.46

97761

Prosthetic Traing 1st Enc

$26.63

97763

Orthc/Prostc Mgmt Sbsq Enc

$33.44

97799

Unlisted Physcl Med/Rehab Px

M

98975

Rem Ther Mntr 1st Setup&Edu

$12.78

98976

Rem Ther Mntr Dev Sply Resp

$30.25

98977

Rem Ther Mntr Dv Sply Mscskl

$30.25

98980

Rem Ther Mntr 1st 20 Min

$32.38

98981

Rem Ther Mntr Ea Addl 20 Min

$25.56

G2250

Remot Img Sub By Pt, Non E/M

$7.88

G2251

Brief Chkin, 5-10, Non-E/M

$8.95

Occupational Therapy – Posted April 1, 2024

Code

Short Description

Private Practice Therapist

92526

Oral Function Therapy

$54.10

92610

Evaluate Swallowing Function

$54.53

95851

Range Of Motion Measurements

$13.85

95852

Range Of Motion Measurements

$11.50

97012

Mechanical Traction Therapy

$8.95

97014

Electric Stimulation Therapy

$7.88

97016

Vasopneumatic Device Therapy

$7.46

97018

Paraffin Bath Therapy

$3.62

97022

Whirlpool Therapy

$10.86

97024

Diathermy Eg Microwave

$4.69

97026

Infrared Therapy

$4.26

97028

Ultraviolet Therapy

$5.33

97032

Appl Modality 1+Estim Ea 15

$9.16

97033

App Mdlty 1+Iontphrsis Ea 15

$12.35

97034

App Mdlty 1+Cntrst Bth Ea 15

$8.95

97035

App Mdlty 1+Ultrasound Ea 15

$8.95

97036

App Mdlty 1+Hubbrd Tnk Ea 15

$22.37

97039

Unlisted Modality

M

97110

Therapeutic Exercises

$18.74

97112

Neuromuscular Reeducation

$21.51

97116

Gait Training Therapy

$18.74

97124

Massage Therapy

$19.38

97129

Ther Ivntj 1st 15 Min

$14.27

97130

Ther Ivntj Ea Addl 15 Min

$13.63

97139

Unlisted Therapeutic Px

M

97140

Manual Therapy 1/> Regions

$17.25

97165

Ot Eval Low Complex 30 Min

$64.75

97166

Ot Eval Mod Complex 45 Min

$64.75

97167

Ot Eval High Complex 60 Min

$64.75

97168

Ot Re-Eval Est Plan Care

$44.73

97530

Therapeutic Activities

$23.43

97533

Sensory Integration

$39.83

97535

Self Care Mngment Training

$20.87

97542

Wheelchair Mngment Training

$20.24

97550

Caregiver Traing 1st 30 Min

$33.87

97551

Caregiver Traing Ea Addl 15

$16.83

97760

Orthotic Mgmt&Traing 1st Enc

$30.46

97761

Prosthetic Traing 1st Enc

$26.63

97763

Orthc/Prostc Mgmt Sbsq Enc

$33.44

97799

Unlisted Physcl Med/Rehab Px

M

98975

Rem Ther Mntr 1st Setup&Edu

$12.78

98976

Rem Ther Mntr Dev Sply Resp

$30.25

98977

Rem Ther Mntr Dv Sply Mscskl

$30.25

98980

Rem Ther Mntr 1st 20 Min

$32.38

98981

Rem Ther Mntr Ea Addl 20 Min

$25.56

G2250

Remot Img Sub By Pt, Non E/M

$7.88

G2251

Brief Chkin, 5-10, Non-E/M

$8.95


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