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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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PTP Practitioner Edits

Practitioner edits apply to physical, occupational, and speech therapists in private practice as well as therapists employed by physician groups.  In addition to our guides we provide ongoing compliance and billing support for members that includes requests for NCCI code pairings and help with modifiers. 

Edits effective on October 1, 2024

PT/OT Evaluations and Re-Evaluations
    • PT Eval; low complexity
    • PT Eval; med complexity
    • PT Eval; high complexity
    • PT Reevaluation
    • OT Eval; low complexity
    • OT Eval; med complexity
    • OT Eval; high complexity
    • OT Reevaluation
Therapeutic Procedures
    • Biofeedback
    • Therapeutic Exercise
    • Neuromuscular Reeducation
    • Aquatic Therapy
    • Gait Training
    • Massage Therapy
    • Therapeutic Intervention; 15 min
    • Therapeutic Intervention; add 15 min
    • Physical Medicine Procedure
    • Manual Therapy
    • Group Therapy
    • Therapeutic Activities
    • Sensory Integrative Techniques
    • Self-Care Management
    • Community/Work Integration
    • Wheelchair Management Training
    • Work Hardening
Modalities
    • Hot or Cold Packs
    • Mechanical Traction
    • Vasopneumatic Devices
    • Paraffin Bath
    • Whirlpool
    • Diathermy
    • Ultraviolet
    • Electrical Stimulation (manual)
    • Iontophoresis
    • Contrast Baths
    • Ultrasound
    • Hydrotherapy
    • Electrical Stimulation (unattended)
    • Electrical Stimulation (Non wound)


Assessments and Orthotics/Prosthetics
    • Range of Motion Measurements
    • Range of Motion; hand
    • Canalith Repositioning
    • Cognitive Testing HC Pro
    • Physical Performance Test
    • Assistive Technology Assessment
    • Orthotic Management
    • Prosthetic Management
    • Orthotic/Prosthetic Management
Wound Care
    • Removal Devitalized Tissue 20cm/<
    • Removal Devitalized Tissue addl 20 cm<
    • Wound Care (non-selective
    • Negative Press Wound tx < 50 cm
    • Negative Press Wound tx > 50 cm
    • Negative Press Wound tx </=50 sq cm
    • Negative Press Wound tx >50 cm
    • Low Frequency, Non-Contact, Ultrasound
Speech Therapy
    • Treatment of Speech; individual
    • Treatment of Speech; group
    • Laryngeal Function Studies
    • Evaluation of Speech Fluency
    • Evaluation of Speech Sound Production
    • Evaluation of Speech with Evaluation of Language Comprehension
    • Behavioral and Qualitative Analysis of Voice and Resonance
    • Treatment of Swallowing Dysfunction
    • Evaluation for Use and/or Fitting of Voice Prosthetic Device
    • Evaluation for Prescription of Speech-Generating AAC Device; first hour
    • Evaluation for Prescription of Speech-Generating AAC Device;  30 minutes
    • Therapeutic Services for Use of Speech-Generating Device
    • Evaluation of Oral and Pharyngeal Swallowing Function
    • Motion Fluoroscopic Evaluation
    • Endoscopic Swallow Evaluation (FEES)
    • Laryngeal Sensory Testing
    • Flexible Fiberoptic Endoscopic Evaluation (FEESST)
    • Assessment of Aphasia
    • Cognitive Assessment


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Therapy Comply is a healthcare compliance firm that seeks to bring high quality web-based compliance guidance and one-on-one consulting services to small and medium size physical, occupational, and speech therapy practices.

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