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LIST OF MODIFIERS

Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...

Therapeutic Activities (CPT code 97530)


Therapeutic activities are considered medically necessary for patients needing a broad range of rehabilitative techniques that involve movement. Movement activities can be for a specific body part or could involve the entire body. This procedure involves the use of functional activities (e.g., bending, lifting, carrying, reaching, catching, and overhead activities) to improve functional performance in a progressive manner. The activities are usually directed at a loss or restriction of mobility, strength, balance, or coordination. They require the professional skills of a therapist and are designed to address a specific functional need of the patient. These dynamic activities must be part of an active treatment plan and be directed at a specific outcome.

In order for therapeutic activities to be covered, the following requirements must be met:

- the patient has a condition for which therapeutic activities can reasonably be expected to restore or improve functioning;

- the patient’s condition is such that he/she is unable to perform therapeutic activities except under the direct supervision of a physician, optometrist or physical therapist; and

- there is a clear correlation between the type of exercise performed and the patient’s underlying medical condition for which the therapeutic activities were prescribed.

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