CPT 97545 can report work conditioning for the first two hours. The add-on code 97546 can be billed for every extra hour that the service is performed.
Underneath the description, guidelines and reimbursement for work conditioning.
97545 CPT Code Description
CPT 97545 is defined by the manual as: “Work hardening/conditioning. Initial 2 hours.”
Work conditioning is thegeneral approach to getting a patient back in a good work condition.
97546 CPT Code Description
CPT 97546 is an add-on code for work conditioning. After the first two hours (bill CPT 97545), the add-on code 97546 can be billed. This code is defined as:
“Work hardening/conditioning. Each additional hour.”
Make sure to list CPT 97546 seperate in addition to CPT code 97545.
Be aware that CPT 97545 will be denied if work hardening is documented, but work conditioning is performed.
Work hardening simulates an occupation for a patient. It’s main goal is to offer the individual exercises to get the patient ready for a particular job.
Therefor work hardening involves specific goals and payers will recognize that it takes longer to perform. Bill more units for more units of CPT 97545 and CPT 97546 for the specific goals.
Medicare does not reimburse work conditioning (CPT 97545 and CPT 97546). These services are related solely to specific work skills, and they are not reasonable or necessary for the diagnosis or treatment of an illness or injury and are not covered.