Updated on: July 25, 2025
Introduction
CPT code 97110 is one of the most frequently used procedural codes in occupational and physical therapy settings. It represents therapeutic exercise aimed at improving strength, endurance, range of motion, and flexibility over intervals of 15 minutes. For both clinical and billing accuracy, understanding this code in depth is essential. This guide covers definitions, common clinical uses, documentation requirements, billing units and rules, coding best practices, related codes, case vignettes, and productivity tools—all aimed at enhancing patient care and reimbursement revenue.
Understanding CPT Code 97110
Definition and Purpose
CPT code 97110 refers to direct one-on-one therapeutic exercise focusing on physical rehabilitation goals such as increasing strength, endurance, joint mobility, and flexibility. Each unit corresponds to up to 15 minutes of face-to-face treatment with the client.
Key Care Components
- Hands-on or guided exercise with the client for one or more body areas
- Activities may include resistance training, stretching, range-of-motion protocols, and cardiovascular endurance exercises
- Therapist must maintain direct engagement, such as verbal, visual, or manual interaction throughout the time
These exercises are individualized, purposeful, and connected to functional goals such as independent mobility, daily living activities, or work-related tasks
Clinical Indications and Use Cases
Post-Surgical Rehabilitation
Clients recovering from surgeries like joint reconstruction, rotator cuff repair, or orthopedic hardware removal often require progressive strengthening and flexibility work. 97110 is used to document structured exercises tailored for their rehabilitation phase
Neurological and Stroke Recovery
Therapeutic exercise under 97110 supports retraining motor strength, coordination, and endurance for those recovering from stroke, traumatic brain injury, or neurodegenerative conditions
Chronic Pain and Mobility Limitation
Individuals dealing with chronic musculoskeletal pain or arthritis benefit from gentle strengthening, joint mobility, and flexibility exercises to improve daily function and reduce pain
Conditioning and Endurance Building
Therapeutic routines used for general conditioning—such as using resistance bands, light weights, or stationary cycling—fall under 97110, especially when focused on long-term independence or prevention of decline
Documentation and Medical Necessity
Core Documentation Elements
- Timed treatment details: record exact minutes spent on 97110 exercises per session
- Exercise description: specify body regions, exercise type (e.g., isotonic, isometric, active assistive) and parameters (sets, repetitions, resistance level)
- Functional goal linkage: connect each exercise to a measurable client goal (e.g., improve hip flexion by 10 degrees to allow safe transfers)
- Client response and progression: note tolerance, improvements, pain levels, and any modifications
- Relevance to diagnosis: justify why therapeutic exercises are essential to the client’s condition and recovery plan
Establishing Medical Necessity
Document that the exercises are:
- Reasonable and necessary to restore or maintain functional capacity
- Supported by client diagnosis and assessed deficits
- Part of a skilled therapist’s intervention not home exercise only
Proper documentation ensures clarity, supports billing legitimacy, and protects against audit risk
Billing Units and the 8-Minute Rule
Time-Based Billing Structure
- CPT 97110 is timed in 15-minute units, each unit reflecting direct therapy contact
- Therapists must accurately track time spent on each activity to calculate billable units
The Medicare 8-Minute Rule
Billing requires:
- At least 8 minutes spent per service to count as one billable unit
- Ranges:
- 8 to 22 minutes = 1 unit
- 23 to 37 minutes = 2 units
- 38 to 52 minutes = 3 units, etc
When multiple timed codes are used in a session, minutes are tracked per code and the largest time blocks determine units billed
Combining Remainder Minutes
If therapists spend less than 8 minutes on one code but combined minutes across codes reach thresholds, remainders may be credited. The code with the highest remaining minutes is billed accordingly
Common Reimbursement Rates and Trends
While rates vary by payer and region, typical averages may include (per unit):
- Therapeutic exercise (97110): approximately $31 per unit
- Other common codes: manual therapy (97140) ~$28/unit; neuromuscular re-education (97112) ~$36/unit; therapeutic activities (97530) ~$40/unit
Rates evolve yearly—staying current ensures accurate billing and informed client communication about potential copays or balances
Related CPT Codes and Service Integration
Frequently Paired Codes
Combining multiple codes allows comprehensive sessions:
- 97112: neuromuscular re-education (balance, proprioception, posture)
- 97140: manual therapy techniques (joint mobilization, manipulation)
- 97530: therapeutic activities (functional dynamic tasks such as transfers, reaching, ADL simulation)
When billing multiple codes in one session, each must meet individual time thresholds and clinical justification
Use of Modifier 59
When overlapping treatments might trigger bundling rules, applying modifier 59 denotes distinct and separate services. Use it only when services are temporally and functionally independent
Telehealth and Remote Billing
In some jurisdictions, CPT 97110 may be billed for telehealth sessions under emergency or temporary billing allowances. Check payer policies to confirm eligibility
Charts for Clinical Use
Chart 1: CPT Code 97110 Overview
| Component | Summary |
|---|---|
| Service Type | Therapeutic exercise interventions |
| Unit Length | 15 minutes direct contact |
| Documentation Required | Time, exercise details, functional goals, response |
| Billing Rule | Must meet 8-minute threshold for each unit |
| Common Usage | Strength, flexibility, endurance, range of motion |
Chart 2: Time-Based Billing Example
| Session Time Allocation | Minutes | CPT Code | Units |
|---|---|---|---|
| Shoulder range-of-motion exercise | 10 | 97110 | 1 |
| Manual joint mobilization | 9 | 97140 | 1 |
| Balance training | 12 | 97112 | 1 |
| Total time | 31 | Combined | 3 |
Chart 3: Common CPT Pairing and Goals
| CPT Code | Description | Common Clinical Goal |
|---|---|---|
| 97110 | Therapeutic exercise | Build strength/endurance/flexibility |
| 97112 | Neuromuscular re-education | Improve coordination/balance/posture |
| 97140 | Manual therapy | Reduce joint restriction or muscle tightness |
| 97530 | Therapeutic activities | Rehabilitate functional tasks and daily performance |
Sample Case Vignettes
Case A: Post-Operative Shoulder Patient
A client recovering from rotator cuff repair needs regimen for shoulder strength and flexibility. Therapist spends 18 minutes on 97110 exercises targeting external rotation and scapular stabilization, resulting in 1 unit. Additional 12 minutes applied to manual technique (97140) for another unit
Case B: Stroke Survivor with Mobility Deficits
Client practices seated leg-strengthening exercises for 24 minutes (97110 = 2 units), 8 minutes of balance training (97112 = 1 unit), and 10 minutes gait training (97116 = 1 unit). Accurate unit calculation ensures full reimbursement and clear therapy tracking
Case C: Chronic Low Back Pain
Client participates in core strengthening and flexibility routines (97110) totaling 20 minutes = 1 unit. Therapist documents improved posture, reduced stiffness, and patient-perceived ease in mobility, supporting treatment continuation
Best Practices and Billing Tips
- Track time precisely using timer or clinical software
- Separate timed codes and log minutes for each independently
- Document rationale clearly linking exercise type to functional goals
- Avoid overlapping time billing by distributing minutes accurately across codes
- Confirm payer policies on bundling rules, modifiers, and telehealth allowances
- Use progress notes to justify continued skilled intervention and support ongoing assessment
Summary and Clinical Takeaways
Mastering CPT code 97110 requires:
- Clear understanding of timed billing rules and documentation standards
- Accurate tracking of time spent on therapeutic exercises
- Strong clinical write-ups justifying necessity and connection to client goals
- Awareness of naturally paired codes and bundling considerations
- Consistent monitoring of reimbursement rates and payer-specific policies
When used with precision and clinical insight, 97110 supports high-quality therapy while optimizing reimbursement and compliance. Integrating this code into workflows with careful documentation and clinical reasoning empowers therapists and billing staff to maximize both therapeutic impact and financial sustainability in rehab settings
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