Physical therapy CPT codes are the five-digit AMA codes that PTs use to bill evaluations, treatments and modalities. The core set is the evaluation codes 97161 to 97164 and the timed treatment codes 97110 (therapeutic exercise), 97112 (neuromuscular re-education), 97140 (manual therapy), 97530 (therapeutic activities) and 97116 (gait training). Timed codes are billed in 15-minute units under the 8-minute rule; evaluations and supervised modalities are billed once per session. For 2026, Medicare's conversion factor is $33.40 for most practices, the KX threshold is $2,480, and three new remote therapeutic monitoring codes were added.

This cheat sheet lists the codes, whether each is timed, 2026 Medicare rates for the most-billed codes, the evaluation tiers, modifiers, the 8-minute rule, documentation rules and the 2026 changes. Use the estimator below to turn minutes into billable units.

Physical therapy CPT codes cheat sheet (2026)

PT billing units and payment estimator

For a single-code check, use our 8-minute rule calculator.

2026 Medicare reimbursement rates for top PT codes

Medicare pays each code as RVUs x a geographic adjustment (GPCI) x the conversion factor. The national amounts below use the 2026 conversion factor of $33.4009 before geographic adjustment. Your local rate differs; check the CMS Physician Fee Schedule Look-Up Tool.

RVUs as summarised from the CMS fee schedule by CareRoute; verify in the CMS tool before using them for contracts. Three rules then cut the amount you receive:

• Multiple procedure payment reduction (MPPR): after the first unit, the practice expense part of each additional "always therapy" unit on the same day is paid at 50%.
• PTA services: services furnished in whole or in part by a PTA carry the CQ modifier and are paid at 85% of the fee schedule amount.
• Patient share: the Part B deductible and 20% coinsurance apply, and sequestration reduces Medicare's share.

The three PT evaluation tiers carry the same RVUs, so Medicare pays 97161, 97162 and 97163 the same amount. Choose the tier that the documentation supports, not the one you think pays more. Commercial and Medicaid rates are set by contract and state fee schedules. More on payment: physical therapy billing and reimbursement and Medicare conversion factor and GPCI changes.

PT evaluation codes 97161, 97162, 97163 and 97164

Re-evaluation (97164) requires an examination with a review of history and standardized tests and measures, plus a revised plan of care. Use it for a significant change in condition, not for routine progress notes. Source: Noridian therapy evaluative procedure codes.

Therapeutic procedure codes: choosing the right one

Bill the code that matches the main purpose of each block of skilled time and document what you did, why and for how long. See our PT documentation cheat sheet for note wording that supports each code.

Supervised vs constant attendance modalities

Supervised modalities (97010 to 97028) do not need one-on-one contact and are billed once per session; Medicare bundles hot and cold packs and does not pay them separately, and it uses G0283 instead of 97014 for unattended electrical stimulation. Constant attendance modalities (97032 to 97039) need direct one-on-one contact and are billed in 15-minute units.

What changed for PT billing in 2026

Sources: WebPT summary of the 2026 final rule and CMS MLN Matters MM14250 (2026 therapy code list). Read our full 2026 CPT code changes guide and how to bill remote therapeutic monitoring.

The 8-minute rule for PT billing units

Medicare adds up all timed minutes in the visit and converts the total into units. At least 8 minutes are needed for one unit.

Example: 30 minutes of 97110 and 15 minutes of 97140 total 45 minutes, which supports 3 units: 2 units of 97110 and 1 unit of 97140. When minutes are left over across codes, the extra unit goes to the service with the most remaining minutes. Untimed codes such as evaluations do not count toward the timed total. Read the full 8-minute rule guide.

PT modifiers you need on claims

NCCI edits for physical therapy

NCCI procedure-to-procedure edits flag code pairs that are not usually billed together. In January 2021 CMS deleted several edits that had hit therapists, including 97530 with 97140, 97530 with 97116 and 97530 with 97164, according to APTA. Edits change every quarter, so check the current CMS NCCI tables before adding modifier 59. More detail: modifier 59 guide and NCCI edits guide.

Documentation that supports PT CPT codes

Rules come from the Medicare Benefit Policy Manual, chapter 15; see CMS therapy services and APTA coding and billing. SPRY documentation and SPRY billing software track timed minutes, progress-note due dates and KX thresholds automatically.

Common PT coding mistakes that cause denials

• Billing units on untimed codes such as evaluations, 97010 or 97150.
• Counting minutes for untimed services toward the 8-minute total.
• Missing GP or KX modifiers, or KX without documentation of medical necessity.
• Adding modifier 59 where no NCCI edit exists, or where services were not distinct.
• Billing 97164 for a routine progress note.
• Missing progress reports every 10 treatment days or late plan of care certification.

Estimate what denials cost you with our claim denial calculator and see strategies to reduce PT claim denials. For practical code tips, Medbridge's PT CPT best practices is also useful. Browse every code in the SPRY CPT code library.

Frequently asked questions

What are the most common physical therapy CPT codes?

97110 (therapeutic exercise), 97112 (neuromuscular re-education), 97140 (manual therapy), 97530 (therapeutic activities), 97116 (gait training) and the evaluation codes 97161 to 97164.

What is the CPT code for a physical therapy evaluation?

97161 (low complexity), 97162 (moderate) or 97163 (high), chosen by history, examination, clinical presentation and decision-making. 97164 is the re-evaluation. They replaced 97001 and 97002 in 2017.

What is the difference between 97110 and 97112?

97110 targets strength, endurance, range of motion and flexibility. 97112 targets balance, coordination, posture, proprioception and movement retraining.

Which PT CPT codes are timed?

Most treatment codes: 97110, 97112, 97116, 97140, 97530, 97535, 97542, 97750, 97760 and constant-attendance modalities such as 97032, 97033 and 97035. Evaluations, 97150 and supervised modalities are untimed.

How does the 8-minute rule work?

Add all timed minutes in the visit. 8 to 22 minutes is 1 unit, 23 to 37 is 2 units, 38 to 52 is 3 units, and so on in 15-minute steps.

What is the 2026 Medicare conversion factor for PT?

$33.40 for clinicians not in a qualifying APM, which covers most PT practices, and $33.57 for qualifying APM participants.

What is the KX modifier threshold for 2026?

$2,480 for PT and speech-language pathology combined, and $2,480 for OT. Claims above it need the KX modifier and documentation of medical necessity. Targeted medical review applies at $3,000.

What are the new PT CPT codes for 2026?

Remote therapeutic monitoring codes 98985 (musculoskeletal, 2 to 15 days), 98984 (respiratory, 2 to 15 days) and 98979 (treatment management, first 10 minutes).

Can I bill an evaluation and treatment on the same day?

Yes, if both are medically necessary and documented. Evaluation time does not count toward the timed-code minutes.

How do I bill group therapy in physical therapy?

Use 97150 once per patient per session. It is untimed, and each patient needs their own plan of care and documentation.

Sources

• WebPT: The 2026 final rule for rehab therapists
• CMS MLN Matters MM14250: therapy code list 2026 annual update
• Noridian Medicare: therapy evaluative procedure codes
• APTA: NCCI coding edit change (2020)
• CMS: NCCI coding edits
• CMS: therapy services
• CMS: Physician Fee Schedule Look-Up Tool
• APTA: coding and billing
• CareRoute: 2026 Medicare payment and RVUs by CPT code
• American Medical Association (CPT code set owner)

CPT is a registered trademark of the American Medical Association. This page is informational and does not replace payer policy or official coding guidance.