Billing Medicare for Home Exercise Programs and Patient Education

Please note that this article contains information that is only relevant to American clinics.


Many facilities treating Medicare patients with outpatient PT, OT, and SLP services often find themselves in situations where they’re either prescribing home exercise programs or providing patient education. And while the two activities are fairly commonplace in the rehabilitation field, there isn’t a specific CPT code that speaks to either activity. In this article, we’ll be discussing how you can bill Medicare for home exercise plans and patient education.


Are you using your clinical management software to track AR? Click here to learn how.


Regardless of whether you are establishing a home exercise program, or providing training for a caregiver, it’s important to ensure that you’ve billed the correct CPT code. Providing training for a caregiver (i.e. a spouse or parent) might include showing them the proper technique to helping a patient use an assistive device to travel up and down a staircase, or showing them how to transfer the patient to a bed. But how do you bill Medicare for this time if there isn’t a specific CPT code describing the nature of the services?


A recent article from Gawenda Seminars and Consulting stated that “You are to bill for the time spent teaching the patient and or caregiver the exercise program or other education provided under the CPT code that best describes what you are teaching them.” The article then went on to provide a few examples.


For instance, if you are teach a patient or their caregiver a strengthening exercise to perform at home, the time spent providing the training would be classified as therapeutic exercise—or in other terms—CPT 97110.


If your therapist spent a session teaching a wife how to transfer her husband from his wheelchair to their bed, that would be considered therapeutic activities, otherwise known as CPT 97530.


Practice Perfect features a direct integration with Physiotec’s home exercise program. To learn more about how this works, click here.


Well, we hope you found this article helpful. For more great content about Medicare, head over to the Gawenda Seminars and Consulting website!

top icon