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CPT Code 97537 | Description & Billing Guidelines

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This article was published more than 1 year ago. While we strive to keep our content up to date, medical coding guidelines and regulations may have changed since then.

Community reintegration (CPT 97537) is performed with other therapeutic procedures, such as gait training and self-care/home management training.

The official description of CPT code 97537 is: “Community/work reintegration training (e.g., shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes.”

The payment for community reintegration training is bundled into the payment for those other services. Therefore, these services are not separately reimbursable by Medicare.

Services related solely to specific employment opportunities, work skills, or work settings are not reasonable and necessary for diagnosing and treating an illness or injury. They are excluded from coverage by Section 1862(a)(1) of the Social Security Act.

This content may be outdated

This article was published more than 1 year ago. While we strive to keep our content up to date, medical coding guidelines and regulations may have changed since then.

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