97161 Insurance Policy Changes

CPT 97161, in plain terms, covers A physical therapist evaluates a patient with straightforward medical needs, spending about 20 minutes on the assessment. CPT 97161 is referenced in 4 tracked payer policy changes from Texas Medicaid, Nevada Medicaid, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 97161 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 97161 on AAPC