97168 Ot re-eval established plan care
Also known as: OT re-eval, Progress check, Plan update
Occupational therapy re-evaluation assessing progress and modifying treatment plan based on functional outcomes.
In Plain Language
Checking progress in occupational therapy
Clinical Context
Periodic assessment to document progress and update treatment goals. Necessary for continued medical necessity.
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 97168?
CPT 97168 (Ot re-eval established plan care) is a Medicine code. Occupational therapy re-evaluation assessing progress and modifying treatment plan based on functional outcomes.
Who uses CPT code 97168?
CPT 97168 is used by Occupational Therapy, Rehabilitation. Periodic assessment to document progress and update treatment goals. Necessary for continued medical necessity.
When is CPT 97168 used?
Periodic assessment to document progress and update treatment goals. Necessary for continued medical necessity.
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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.