Physical Therapy Avg. $32

CPT 97110: Therapeutic Exercises

Therapeutic procedure, one or more areas, each 15 minutes: therapeutic exercises to develop strength, endurance, flexibility, and range of motion.

Why CPT 97110 Claims Get Denied

Claims billed under CPT 97110 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.

Visit limit or therapy cap exceeded

Medical necessity not established for continued therapy

Prior authorization not obtained or expired

Functional improvement not documented

Billing Tips for CPT 97110

Bill in 15-minute units using the 8-minute rule (8+ minutes of a unit = bill 1 unit). Document functional goals and measurable progress. For Medicare, be aware of the therapy threshold ($2,330 combined PT/SLP and $2,330 OT in 2025) where KX modifier is required to attest medical necessity. Report the appropriate G-code functional measures.

Documentation Requirements

To support a clean claim for CPT 97110, your clinical documentation should include:

Type of exercises performed

Duration of the treatment

Body areas treated

Patient response and progress toward goals

Functional outcome measures

Updated treatment plan with remaining visits

Common Modifiers for CPT 97110

Modifier 59
Modifier GP
Modifier KX

Reduce CPT 97110 Denials by 60%

RediClaim's pre-submission scrubber catches documentation gaps and coding errors before you submit, while the appeal generator handles denials that slip through.

Stop losing revenue to preventable denials

RediClaim generates appeal letters, scrubs claims before submission, and optimises your coding — in seconds, not hours.