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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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North Carolina Medicaid Physical Therapy Rates

North Carolina Medicaid rates for physical 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 contact us to request additional codes or updates.  

Updated November 6, 2024

Code

Description

Facility Rate

Non-Facility Rate

29075

Application Of Forearm Cast

$44.98

$61.09

29085

Application Hand/Wrist Cast

$48.51

$65.19

29105

Application Long Arm Splint

$43.88

$60.56

29125

Application Forearm Splint

$31.26

$46.80

29126

Application Short Arm Splint Dynamic

$38.46

$54.00

29130

Application Finger Splint Static

$21.81

$28.88

29131

Application Finger Splint Dynamic

$24.45

$35.48

29240

Strapping Of Shoulder

$33.59

$42.65

29260

Strapping Of Elbow Or Wrist

$27.67

$36.71

29280

Strapping Of Hand Or Finger

$26.06

$35.39

29405

Application Short Leg Cast

$47.92

$62.62

29425

Application Short Leg Cast

$52.99

$67.96

29505

Application Long Leg Splint

$35.35

$53.17

29515

Application Lower Leg Splint

$37.05

$50.06

29530

Strapping Of Knee

$28.28

$37.32

29540

Strapping Of Ankle And/Or Ft

$25.23

$30.87

92526

Treatment Of Swallowing Dysfunction And/Or Oral Function For Feeding

$22.28

$62.42

92610

Eval Of Swallowing And Oral Function For Feeding

$60.34

$60.34

95885

Musc Tst Done W/Nerv Tst Lim

$30.88

$30.88

95886

Musc Test Done W/N Test Comp

$48.68

$48.68

95907

Nvr Cndj Tst 1-2 Studies

$73.32

$73.32

95908

Nrv Cndj Tst 3-4 Studies

$90.52

$90.52

95909

Nrv Cndj Tst 5-6 Studies

$108.44

$108.44

95910

Nrv Cndj Test 7-8 Studies

$142.78

$142.78

95911

Nrv Cndj Test 9-10 Studies

$172.99

$172.99

95912

Nrv Cndj Test 11-12 Studies

$202.69

$202.69

95913

Nrv Cndj Test 13/> Studies

$235.09

$235.09

95992

Canalith Repositioning Procedure(S) Treatment Of Vertigo, Per Day

$34.06

$37.54

97010

Application Of A Modality To 1 Or More Areas; Hot Or Cold Packs

$3.71

$3.71

97012

Physical Med Treatment One Area Traction

$11.79

$11.79

97016

Physical Med Treatment Vasopneumatic Devices

$12.19

$12.19

97018

Physical Med Treatment Paraffin Bath

$6.27

$6.27

97022

Physical Medicine Treatment Whirlpool

$13.87

$13.87

97024

Physical Medicine Treatment Diathermy

$4.29

$4.29

97026

Physical Medicine Treatment Infrared

$4.01

$4.01

97028

Physical Medicine Treatment One Area Ultraviolet

$4.90

$4.90

97032

Application Of A Modality To One Or More Areas;

$13.20

$13.20

97033

Apply Modality To 1 Or More Areas; Iontophoresis Ea. 15 Minutes

$19.44

$19.44

97034

Application Of A Modality To One Or More Areas;

$11.98

$11.98

97035

Apply Modalitiy To 1 Or More Areas; Ultrasound, Each 15 Minutes

$9.44

$9.44

97036

Application Of A Modality To One Or More Areas;

$20.34

$20.34

97110

Therapeutic Procedure, One Or More Areas, Each 15 Minutes; Therapeutic

$22.90

$22.90

97112

Therapeutic Procedure, One Or More Areas, Each 15 Minutes; Neuromuscular

$23.55

$23.55

97116

Therapeutic Procedure, One Or More Areas, Each 15 Minutes; Gait Training

$20.05

$20.05

97124

Therapeutic Procedure, One Or More Areas, Each 15 Minutes; Massage, Including

$18.24

$18.24

97140

Manual Therapy Techniques

$21.25

$21.25

97161

Evaluation Of Physical Therapy, Typically 20 Minutes

$66.11

$66.11

97162

Evaluation Of Physical Therapy, Typically 30 Minutes

$66.11

$66.11

97163

Pt Eval High Complex 45 Min

$66.11

$66.11

97164

Pt Re-Eval Est Plan Care

$44.80

$44.80

97530

Therapeutic Activities, Direct (One On One) Patient Contact By Th

$24.10

$24.10

97533

Sensory Integrative Techniques To Enhance Sensory Processing And Promote

$21.27

$21.27

97535

Self-Care/Home Management Training (Eg, Activities Of Daily Living (Adl) And

$24.13

$24.13

97542

Wheelchair Management/Propulsion Training, Each 15 Minutes

$22.15

$22.15

97602

Non-Selective Debridement

$14.63

$14.63

97750

Physical Performance Test Or Measurement (Eg, Musculoskeletal,

$23.46

$23.46

97760

Orthotic management & training 1st encounter

$25.91

$25.91

97761

Prosthetic Traing 1st Enc

$23.18

$23.18

97763

Orthc/Prostc Mgmt Sbsq Enc

$26.40

$26.40


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