2025 Coding and Payment Guide for Physical Therapy/Rehabilitation/Physical Medicine (Spiral)
Optum | 2025 |
The Coding and Payment Guide for the Physical Therapist is your one-stop coding, reimbursement, and documentation resource developed exclusively for physical, occupational and speech therapy, rehabilitation, and physical medicine. This comprehensive and easy-to-use guide is updated for 2025 and organized by specialty-specific CPT® codes. Each code includes its official description and lay description, coding tips, documentation and reimbursement tips, Medicare edits, and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.
PDF: Compare Optum Coding and Payment Guides to other industry books (199KB).
PDF: Compare Optum Coding and Payment Guides to other industry books (199KB).
- Evaluation and Management Services. Evaluation and Management codes commonly used in your specialty with their official description and lay description, coding tip, Medicare edits, and relative value units.
- Evaluation and Management (E/M) Services Guidelines – E/M codes are used every day in your practice. With CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.
- Procedure code icons – Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures quick and efficient.
- ICD-10-CM code icons – Icons identify age-related and laterality diagnosis codes.
- HCPCS Level II Chapter – HCPCS supply and procedure codes commonly used in your specialty listed in alpha numeric order for easy access.
- Quickly find information. All the information you need is provided, including CPT® full code descriptions, lay descriptions, coding tips, procedure code-specific documentation and reimbursement tips, post op or follow up days, Medicare edits including IOM references and Medicare Unlikely Edits designations (MUE), and commonly associated ICD-10-CM diagnosis codes.
- CPT® Assistant references. Identify that an article or discussion of the CPT code has been in the American Medical Association’s CPT® Assistant newsletter. Use the citation to locate the correct volume.
- Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with total RVUs for non-facility and facility for CPT codes also included.
- Helpful illustrations. Chapter of detailed anatomical illustrations.
- CCI edits. CCI Edits for CPT® and HCPCS procedure codes are included with quarterly updates available online at Optumcoding.com Product Update page.
CPT® is a registered trademark of the American Medical Association.
Nannette Orme, CCS-P
Ms. Orme has more than 30 years of experience in the healthcare profession. She has extensive background in CPT/HCPCS and ICD-9-CM coding and has completed comprehensive ICD-10-CM and PCS training. Her prior experience includes physician clinics and healthcare consulting. Her areas of expertise include physician audits and education, compliance and HIPAA legislation, litigation support for Medicare self-disclosure cases, hospital chargemaster maintenance, workers' compensation, and emergency department coding. Ms. Orme has presented at national professional conferences, contributed articles for several professional publications, and served on the advisory board of a local college. She is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
Jacqueline Petersen, MHA, RHIA, CHDA, CPC
Ms. Petersen is a Registered Health Information Administrator with 30 years of experience in the healthcare profession. She has served as Senior Clinical Product Research Analyst with Optum developing business requirements for edits to support correct coding and reimbursement for claims processing applications. Her experience includes development of data-driven and system rules for both professional and facility claims and in-depth analysis of claims data inclusive of ICD-10-CM, CPT, HCPCS, and modifiers. Her background also includes consulting work for Optum, providing coding and reimbursement education to internal and external clients. Ms. Petersen is a member of the American Academy of Professional Coders (AAPC), and the American Health Information Management Association (AHIMA).
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