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Physical Medicine and Rehab
1. If a physician writes a prescription and includes two conditions for a physical therapist to evaluate and treat, can the physical therapist evaluate each condition on separate date of service and bill procedure code 97001 (Physical therapy evaluation) twice? (Last Reviewed: July 16, 2008)
1. If a physician writes a prescription and includes two conditions for a physical therapist to evaluate and treat, can the physical therapist evaluate each condition on separate date of service and bill procedure code 97001 (Physical therapy evaluation) twice? (Last Reviewed: July 16, 2008)
Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §220A, provides us with a definition for an evaluation.
"EVALUATION is a separately payable comprehensive service provided by a clinician, as defined above, that requires professional skills to make clinical judgments about conditions for which services are indicated based on objective measurements and subjective evaluations of patient performance and functional abilities. Evaluation is warranted e.g., for a new diagnosis or when a condition is treated in a new setting. These evaluative judgments are essential to development of the plan of care, including goals and the selection of interventions."
Since the scenario in your question does not warrant an additional evaluation, procedure code 97001 should only be billed once.
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Physical Medicine and Rehab