The 97112 CPT code can be used to report neuromuscular reeducation of movement as therapeutic procedure. It is considered medically necessary if at least one of the three conditions are present. Reimbursement for CPT 97112 is $35.24.
97112 CPT Code Description
CPT 97112 is time specific and is billed in 15-minute increments. According to CMS guidelines, at least eight minutes of Doctor’s direct contact with the patient should been provided for a single unit of service to be appropriately billed.
The 97112 CPT code can be used for neuromuscular reeducation of movement as therapeutic procedure (for 1 or more areas) for;
- kinesthetic sense;
- or/and proprioception for sitting;
- or/and standing activities.
Medical Necessity & Guidelines
The 97112 CPT code can be reported if considered medically necessary. At least one of the following conditions is present and documented:
- the patient has the loss of deep tendon reflexes and vibration sense accompanied by paresthesia, burning, or diffuse pain of the feet, lower legs, and/or fingers;
- the patient has muscular weakness or flaccidity as a result of a cerebral dysfunction, a nerve injury or disease, or has had a spinal cord disease or trauma, or
- the patient has nerve palsy, such as peroneal nerve injury causing foot drop.
AMA guidelines about time addition states that interval of increments of treatment performed on the same session by same provider should be added together when we are determining the total time.
The CMS amount for the 97112 CPT Code is $35.24 for both office and non-office settings.
Be sure to check other third-party payers for reimbursement guidelines for CPT 97112.