CPT Codes

CPT Codes: What They Are and Why They Matter

CPT stands for Current Procedural Terminology. These are standardized codes used by healthcare providers to describe medical, surgical, and diagnostic services during billing. Managed by the American Medical Association (AMA), they serve as the backbone of health insurance reimbursement in the U.S.

What are CPT codes?

Each CPT code is a five-digit number that corresponds to a specific healthcare procedure or service. For example, 97110 refers to “therapeutic exercise” — a commonly used code in physical and occupational therapy.

Why CPT codes matter in therapy practices

For therapy clinics, CPT codes aren't just for compliance — they’re critical for getting paid accurately and efficiently. A mistyped or outdated code can mean denied claims, delayed reimbursements, or compliance issues.

  • Faster payments: Correct codes reduce rejections.
  • Operational clarity: Standardized codes help align staff and systems.
  • Better insights: Track reimbursable services more easily.

How CPT coding works: a simple breakdown

CPT codes are grouped into three categories:

  1. Category I – Standard procedures and services.
  2. Category II – Optional tracking codes.
  3. Category III – Temporary codes for emerging procedures.

Each code includes five digits and may use modifiers to add context (e.g. 95 for telehealth).

Example: 97153 = Adaptive behavior treatment. Modifier 95 = telehealth. Together, these specify what was done, how, and where.

Common CPT codes in therapy clinics

CodeDescription97153Adaptive behavior treatment (ABA therapy)92507Speech-language therapy, individual97110Therapeutic exercise97112Neuromuscular re-education90832Psychotherapy, 30 minutes97151Behavior identification assessment96101Psychological testing

Real-world scenarios: billing smarter

Example: A therapist provides 2 hours of ABA therapy. The correct coding might be:

  • 97153 x 8 units (15-min increments)
  • Modifier 95 if telehealth
  • Location code 11 (clinic) or 02 (telehealth)

Incorrect coding leads to denials and wasted time. Accurate CPT use means smoother billing and more time for patient care.

🔗 Check the AMA’s CPT code search tool

FAQs about CPT codes

1. Who creates and updates CPT codes?

The AMA updates CPT codes annually to reflect medical advances.

2. What’s the difference between CPT and ICD codes?

CPT codes describe procedures; ICD codes describe diagnoses.

3. Do therapy clinics need to use modifiers with CPT codes?

Yes, especially for telehealth or unusual delivery methods.

4. What happens if I use the wrong CPT code?

You may face delays, denials, or audits.

5. How can I train my staff to use CPT codes correctly?

Use cheat sheets, certified coders, and keep up with AMA updates.

Final thoughts

Understanding CPT codes is essential for therapy clinics aiming to operate efficiently. It ensures accurate billing, reduces admin friction, and helps teams focus more on patients — not paperwork.