Physical performance test or measurement, reported in 15-minute units, requiring a written report of results.

Verified May 8, 2026 · 7 sources ↓

Medicare: $33.73
Total RVUs: 1.01
Global, days
Region: General

Drawn from CMSAAPCExpressmbsLinkedinGawendaseminars

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Written report of test results is required — verbal summary or progress note entry does not satisfy the billing requirement.
Record total face-to-face time in minutes to support unit count under the CMS 8-Minute Rule.
Identify the specific tests performed (e.g., isokinetic strength, balance assessment, functional capacity battery) — generic references to 'testing' are an audit flag.
Document medical necessity: state the clinical question the test was designed to answer (return-to-work, rehab baseline, post-op functional status).
Note provider credentials and applicable discipline modifier (GP for PT, GO for OT); if a PTA or OTA performed the test, document supervision and apply CQ or CO.
Exclude time spent on subjective questioning, routine progress updates, or note documentation from the billed 97750 time.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

59 Distinct service KX Documentation on file 52 Reduced services 76 Repeat, same physician 77 Repeat, another physician

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 97750 covers objective assessment of a patient's physical performance — strength, endurance, flexibility, balance, and functional capacity — administered face-to-face and documented in a written report. It is a timed code billed in 15-minute increments under the CMS 8-Minute Rule: 8–22 minutes = 1 unit, 23–37 minutes = 2 units, and so on. The written report is not optional; it is a billing requirement, not just good practice.

This code is used most often by physical and occupational therapists to document functional baselines, measure rehabilitation progress, or support return-to-work determinations such as a Functional Capacity Evaluation (FCE). Orthopedic surgeons and their clinical staff also bill it in the context of post-operative functional assessment. Therapy discipline modifiers (GP, GO, GN) apply when billed under outpatient therapy benefit. Assistant modifiers CQ and CO apply when a PTA or OTA performs the test.

97750 cannot be billed for time spent asking subjective progress questions, gathering routine updates, or writing a progress note. That time folds into other timed therapy codes billed the same day. Many payers also bundle 97750 with a same-day evaluation or re-evaluation by the same discipline — verify payer policy before stacking those on the same date of service.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.45
Practice expense RVU	0.55
Malpractice RVU	0.01
Total RVU	1.01
Medicare national rate	$33.73
Global period	days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$33.73

Common denial reasons

The recurring reasons claims for CPT 97750 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

No written report in the record — payers audit for this specifically; a progress note does not substitute.
Billed same-day as a therapy evaluation or re-evaluation by the same discipline; many payers consider this bundled.
Time documentation insufficient to support units billed — audit teams recalculate units from start/stop times.
Missing or incorrect discipline modifier (GP, GO) when billed under Medicare outpatient therapy benefit.
97750 billed for progress report writing or routine subjective re-assessment — this is a documented non-covered use.
Exceeding payer-imposed unit limits per session without documentation justifying extended testing time.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can 97750 be billed for writing a progress report?

No. Time spent on subjective questioning, gathering progress updates, or documenting findings cannot be billed as 97750. That time is folded into other timed therapy codes billed that day. This rule applies to Medicare and commercial payers alike.

02How many units of 97750 can be billed per session?

Units are determined by total face-to-face testing time under the CMS 8-Minute Rule. Most payers expect one to two units for a standard functional assessment. Billing beyond two units requires documentation showing the extended time was clinically necessary and distinct from other timed services billed the same day.

03Can 97750 be billed on the same day as a therapy evaluation (97161–97163)?

Many payers, including traditional Medicare, do not reimburse 97750 on the same date of service as a therapy evaluation or re-evaluation by the same discipline. Verify payer-specific policy before combining these on the same claim.

04Can a PTA or OTA bill 97750?

Yes, with the appropriate assistant modifier — CQ for a physical therapist assistant, CO for an occupational therapy assistant. Supervision requirements and any associated payment reductions under Medicare apply.

05Is modifier KX required for 97750 under Medicare?

Modifier KX is required when billing Medicare once a patient has met the therapy cap threshold, attesting that the service is medically necessary and meets the exceptions criteria. Missing KX on claims above the threshold is a common denial trigger.

06What distinguishes 97750 from 97110 or 97530?

97110 is therapeutic exercise — active treatment to build strength or function. 97530 is therapeutic activity — functional task practice. 97750 is a measurement, not treatment. If you're testing and documenting performance to answer a clinical question, that's 97750. If you're training the patient, it's not.

07Does the time to document test results count toward billable 97750 time?

No. Only direct face-to-face time administering the tests counts toward billable units. Documentation time, including writing the required report, does not count and cannot be included in the timed minutes used to calculate units.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the specific tests performed, the total face-to-face time in minutes, and the clinical reason for testing directly from dictation — then flags if a written report section is absent before the note is finalized. That prevents the two most common 97750 denials: missing written report and insufficient time documentation to support the billed unit count.

See how Mira captures CPT 97750 documentation