CPT (Current Procedural Terminology) codes, maintained by the American Medical Association (AMA), provide a standardized way to describe medical, diagnostic, and therapeutic procedures. CPT code 97535 is one of the most essential codes for therapy professionals, particularly within the scope of physical and occupational therapy services.
At Cures Billing Services, we simplify complex medical billing processes and ensure accurate claims for services like those covered under the 97535 CPT code.
97535 CPT codes refer to self-care and home management training provided by healthcare professionals to help patients regain independence in daily life after an illness, surgery, or injury.
97535 CPT Code Descriptions:
This code covers training in:
It’s commonly used in occupational therapy and physical therapy sessions.
Common Scenarios:
97535 CPT Code Example:
A therapist trains a stroke patient on how to dress independently using adaptive tools. The session lasts 30 minutes (billed as 2 units).
Eligible Providers:
Time-Based Billing:
Required Documentation:
Use complete medical notes or time-tracking tools to avoid denials.
Yes. When billing 97535 with other treatment codes, such as:
You may need to append modifier -59 to show that the services were distinct and separately identifiable.
97535 CPT Code Reimbursements:
Important:
Some payers require prior authorization for 97535. Always verify requirements to avoid claim denials.
In physical therapy, 97535 is used when therapists train patients to perform self-care tasks post-surgery, after injury, or during long-term care transitions.
Examples:
In occupational therapy, this code supports patients’ learning:
Stroke Recovery (OT)
Post-Surgery Rehab (PT)
CPT Code 97535 is essential in therapy billing for patients who need help regaining independence. Accurate coding, proper documentation, and payer verification are key to successful reimbursement.
At Cures Billing Services, we support therapists and clinics with end-to-end billing services to reduce denials, increase payments, and stay compliant with payer guidelines.
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It’s for exercise patients in self-care and home management to improve daily living independence.
OTs, PTs, and qualified providers per payer policy.
Yes, with proper documentation and modifiers (like -59).
Sometimes. It depends on the insurance company (including Medicare).
Yes if the payer accepts it. Always confirm before the session.
It varies by region and payer. Use the Medicare Fee Schedule or consult with Cures Billing Services to determine your rate.
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