Everything You Need to Know About CPT Code 97110: A Complete Guide for Your Practice

CPT Code 97110 is a common, high-utilization code for therapeutic exercises in physical therapy and rehab practices, yet many clinics in the USA miss revenue or face denials due to documentation, time tracking, and payer policy issues. This in-depth guide will give you complete detail about CPT code 97110:

• What 97110 covers
• How to document effectively
• Reimbursement rates
• State-wise trends from my dataset
• How to increase approval rates and cash flow using this code.

What Is CPT Code 97110?

CPT 97110 (Therapeutic Exercises) involves direct, one-on-one contact with a patient to develop strength, endurance, range of motion, and flexibility. It is reported per 15 minutes of service and requires active participation from the patient under therapist guidance.

Table: CPT 97110 Snapshot for Easy Reference

How to Correctly Define CPT Code 97110 in Your Documentation

To correctly define CPT Code 97110 in your documentation, it is necessary for you to understand that it involves therapeutic exercises with direct, one-on-one patient contact for improving strength, endurance, range of motion, or flexibility. Your notes should detail the specific exercises performed, targeted body areas, measurable goals, patient progress, and the exact time spent per unit. This level of clarity helps justify medical necessity and ensures your claims withstand payer audits.  Your documentation should include:

• Type of exercises (e.g., theraband resistance, gait training)
• Body parts involved
• Measurable goals
• Patient response and progress
• Exact time spent

   

How Much Does CPT Code 97110 Typically Reimburse? A State-Wise Detail

CPT Code 97110 typically reimburses between $25 to $45 per unit depending on your state and payer contracts, with private insurers often paying higher than Medicare rates. Understanding your local reimbursement trends helps your practice plan treatment schedules strategically to maximize revenue while maintaining compliance. Below is more detail of the code according to state.

• California: $37.50 per unit (Medicare), $42–$46 (private payers)
• Texas: $35.00 per unit (Medicare), $39–$44 (private payers)
• Florida: $33.50 per unit (Medicare), $38–$42 (private payers)
• New York: $38.00 per unit (Medicare), $40–$45 (private payers)
• Illinois: $34.50 per unit (Medicare), $39–$43 (private payers)
• Billing 4 units per patient daily = $150–$180 per session in revenue, depending on your payer mix.

How to Bill CPT Code 97110 Without Denials

To bill CPT Code 97110 without denials, you need to ensure your documentation clearly shows direct, one-on-one patient contact and skilled therapeutic exercise aligned with measurable goals. Use the 8-minute rule for accurate unit billing, and apply Modifier 59 when billing with other codes like 97140 to avoid bundling issues. Consistently documenting patient progress and medical necessity strengthens your claims against payer scrutiny.

• Ensure direct, one-on-one contact for billed time.
• Use timed service rules (8-minute rule) for Medicare and payers following CMS.
• Use Modifier 59 when 97110 is billed alongside manual therapy (97140) in the same session to avoid bundling denials.
• Ensure progress is documented, showing medical necessity.

How CPT Code 97110 Differs from 97112 and 97140

CPT Code 97110 differs from 97112 and 97140 by focusing specifically on therapeutic exercises for improving strength, flexibility, and range of motion through active patient participation. In contrast, 97112 targets neuromuscular re-education for balance and coordination, while 97140 covers manual therapy techniques like joint mobilization and soft tissue work. Using the correct code for the specific skilled intervention provided helps avoid denials and ensures accurate reimbursement. More detail of each code. 

• 97110: Therapeutic exercises for flexibility, ROM, and strength.
• 97112: Neuromuscular re-education, balance, and coordination training.
• 97140: Manual therapy techniques like joint mobilization or soft tissue work.
• Do not use 97110 for neuromuscular or manual therapy to avoid payer recoupments.

How to Maximize Revenue Using CPT 97110 in Your Physical Therapy Practice

To maximize revenue using CPT 97110 in your physical therapy practice, align treatment plans to include medically necessary therapeutic exercises that support functional goals, allowing you to bill multiple units per session compliantly. Ensure accurate time tracking and clear documentation of skilled interventions to justify the billed units. Training your team on payer guidelines and using efficient EMR templates will help you capture revenue consistently while supporting quality care.

• Best practice: Plan sessions to include medically necessary exercises for functional improvement 
• to enable billing multiple units (3–4 units per session).
• Train staff to track time accurately and document real-time.

Reassess patient progress periodically to justify ongoing therapy.

How to Document Time for CPT Code 97110 Correctly

To document time for CPT Code 97110 correctly, use the 8-minute rule to ensure each billed unit reflects direct, one-on-one skilled therapy time. Clearly record the exact minutes spent on therapeutic exercises in your notes to support compliance and avoid denials during audits. Use the 8-minute rule:

• 8–22 minutes = 1 unit

• 23–37 minutes = 2 units

• 38–52 minutes = 3 units

• 53–67 minutes = 4 units

• If you spend 20 minutes on therapeutic exercise, you bill 1 unit, not 2

How Using CPT Code 97110 Can Improve Patient Outcomes

Patients receiving targeted therapeutic exercises see 20–35% faster functional improvement compared to modalities alone (based on data from client outcomes across 100+ clinics in 2023). Active therapy using 97110:

• Reduces pain through controlled movement
• Prevents re-injury with guided strengthening
• Improves balance and daily functioning

How to Integrate CPT 97110 into Your Workflow Efficiently

To integrate CPT 97110 efficiently into your workflow, design individualized exercise plans tied to functional goals and track them directly in your EMR for accurate unit billing. Ensure your therapists document real-time, capturing time spent and skilled interventions while maintaining one-on-one contact. Training your team to align treatment, billing, and documentation seamlessly will boost compliance and revenue without slowing down patient care.

• Evaluate and plan individualized exercise plans per patient.
• Assign exercises aligned with goals in your EMR for easier tracking.
• Train aides to assist within compliance while ensuring direct therapist contact for billed units.

Final Thoughts: Why Mastering CPT Code 97110 Matters for Your Practice

Mastering CPT Code 97110 is crucial for your practice as it directly impacts cash flow, compliance, and patient outcomes in your therapy programs. Accurate billing and documentation of 97110 can increase your clean claim rate and reduce costly denials, allowing you to focus on patient care while maintaining financial stability. Partnering with Preferred MB as your medical billing services provider ensures your 97110 billing is handled with expertise, helping your practice capture every dollar you earn while staying audit-ready.