CPT Codes For Occupational Therapy Evaluations

Below is a list summarizing the CPT codes for occupational therapy evaluations.

CPT Code 97165

CPT 97165 describes an occupational therapy evaluation of low complexity that includes an occupational profile, medical and therapy history, assessment of 1-3 performance deficits, and clinical decision-making of low complexity, with no comorbidities that affect occupational performance and no need for modification of tasks or assistance with assessment. Typically, 30 minutes are spent face-to-face with the patient and/or family.

CPT Code 97166

CPT 97166 describes an occupational therapy evaluation of moderate complexity, which includes an occupational profile, medical and therapy history, assessment(s) to identify performance deficits, and clinical decision-making of moderate analytic complexity. The evaluation may require minimal to moderate modification of tasks or assistance to enable the patient to complete the evaluation component. 45 minutes are typically spent face-to-face with the patient and/or family.

CPT Code 97167

CPT 97167 describes an occupational therapy evaluation of high complexity, which includes an occupational profile, medical and therapy history, assessment of 5 or more performance deficits, clinical decision-making of high analytic complexity, and consideration of comorbidities that affect occupational performance. Significant modification of tasks or assistance is necessary to enable the patient to complete the evaluation component, typically taking 60 minutes of face-to-face time with the patient and/or family.

CPT Code 97168

CPT 97168 describes a formal reevaluation of an established plan of care for occupational therapy, which includes an assessment of changes in patient functional or medical status, an update to the initial occupational profile, and a revised plan of care, typically requiring 30 minutes of face-to-face time with the patient and/or family.