Prior Auth Required

97163 - Physical therapy evaluation; high complexity requiring components

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePhysical therapy evaluation; high complexity requiring components
Procedure / Service Description

Group adaptive behavior treatment with protocol modification, administered by physician or - 97161 Physical therapy evaluation; low complexity, requiring components 97162 Physical therapy evaluation; moderate complexity requiring components 97163 Physical therapy evaluation; high complexity requiring components 97164 Reevaluation of physical therapy established plan of care requiring components 97165 Occupational therapy evaluation; low complexity requiring components

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.