Coding and billing resources
Get paid for the services you deliver. AOTA provides clear, easy-to-understand resources that will help you code and bill correctly. Still have questions?
Bill with confidence
AOTA members now have access to AOTA’s Medicare Fee Schedule Calculator, designed to help navigate the complexities of Medicare reimbursement, allowing you to determine payment for your services in one convenient location.
Video training resources
Watch these short videos to learn more about coding and billing. And access the resources below for tips on how to select the right codes.
More videos about coding and billing
Watch these short videos to learn more about coding and billing. And access the resources below for tips on how to select the right codes.
Occupational therapy evaluation and re-evaluation codes
Coding is essential not only for proper reimbursement, but also because it is used as a tracking tool by CMS and other agencies to inform how occupational therapy is practiced. These tips will help you select the most appropriate evaluation codes.
Diagnosis coding resources
The ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) system, replaced the ICD-9-CM (9th Revision) on October 1, 2015. AOTA developed the following resources to help occupational therapists deal with the continuing challenges of ICD-10-CM.
The treating diagnosis is not always the primary medical diagnosis. Use the diagnosis that most appropriately describes the condition you are treating. More than one diagnosis may be appropriate. Do include any comorbidities that are affecting treatment. If possible, avoid unspecified codes.
CPT (procedural) coding resources
These tips will help you select the most appropriate intervention codes.
Interventions
Intervention CPT® codes are deliberately non-specific so that they can apply to various types of therapeutic scenarios. Therefore, in choosing an intervention code, the intent of the intervention should be a driving factor. What are you trying to achieve therapeutically? Review a complete list of commonly used occupational therapy CPT codes.
Orthotics
CPT® codes for orthotic and prosthetic management and training can be used for orthotic evaluation, selection, fabrication, and training.
Timed CPT codes
Understand different payer methodologies for billing time-based occupational therapy intervention codes.
Modifiers
Learn when and how to use modifiers for successful reimbursement.
NCCI edits
The Medicare National Correct Coding Initiative (NCCI; also known as CCI) was implemented to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Medicare Part B claims. NCCI Edits are updated quarterly to prevent improper payments when incorrect code combinations are reported.
NCCI Edits only apply to Medicare Part B services. State Medicaid agencies and other third-party and commercial payers are also required to use CCI Edits but may modify them to meet their own programmatic needs. Please check with non-Medicare payers regarding their use of CCI Edits.
Resources for children and youth
Review resources on commonly billed codes for children and youth.
Pediatric billing and coding tips and tools
Download this resource for billing and coding resources specific to pediatrics.
Which codes to use for developmental testing: Understanding CPT® 96112
Learn how to appropriately code for developmental testing.