97164 Pt re-eval established plan care
Also known as: PT re-eval, Progress evaluation, Plan modification
Physical therapy re-evaluation assessing progress toward established treatment plan goals and modifying care plan as needed.
In Plain Language
Checking progress in physical therapy
Clinical Context
Performed periodically to document progress and adjust treatment. Required for medical necessity documentation.
RVU Breakdown
| Work RVU | 0.96 |
| Total RVU | 0.96 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
Medicine section codes cover a wide range of non-surgical services. Documentation should include the clinical indication, procedure details, interpretation (if applicable), and any patient-specific findings.
How This Code Compares
With a work RVU of 0.96, this code ranks in the 57th percentile among Medicine codes — 1.2x the median (0.78). The highest wRVU in this category is 23.92.
Specialties
Frequently Asked Questions
What is CPT code 97164?
CPT 97164 (Pt re-eval established plan care) is a Medicine code. Physical therapy re-evaluation assessing progress toward established treatment plan goals and modifying care plan as needed.
Who uses CPT code 97164?
CPT 97164 is used by Physical Therapy, Rehabilitation. Performed periodically to document progress and adjust treatment. Required for medical necessity documentation.
When is CPT 97164 used?
Performed periodically to document progress and adjust treatment. Required for medical necessity documentation.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.