Therapy Timeframes

Expected Timeframes for Therapy Services

CMS and CPT guidelines for provider time spent and documented on therapy services may vary, depending on the definition of the service and the context in which it is performed.

Therapy services include:

This chart includes times as defined by CPT coding and the actual timeframes that are expected when performing the services. The time must be spent by the performing/billing provider and documented in the medical record.

Physical/Occupational Therapy

CPT Code Defined Time Expected Time
Refer to LCD: Outpatient Physical and Occupational Therapy Services (L33631) and accompanying Billing and Coding Article: Outpatient and Occupational Therapy Services (A56566)  Refer to: Billing and Coding Article: Outpatient and Occupational Therapy Services (A56566)
 		 8–15 minutes per unit

Examples:
CPT Codes 97035 and 97110:
  • 5 minutes of 97035
  • 7 minutes of 97110
Total = 12 minutes, converts to 1 unit of service CPT

Codes 97110 and 97140:
  • 20 minutes of 97110
  • 20 minutes of 97140
Total = 40 minutes, converts to 2 units of service (would need 45 total minutes to convert to 3 units of service)

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Medical Nutrition Therapy

Category CPT Code(s) Defined Time Expected Time
Individual 97802 – initial

97803 – initial reassessment		 15 minutes

15 minutes		 8–15 minutes, maximum 8 units of service/day For diagnosis of renal disease or diabetes: total time expected per year:
  • Year 1: 3 hours/ year
  • Year 2 forward: 2 hours/ year
Group 97804 – 2 or more patients 30 minutes 30 minutes
Individual G0270 – 2nd annual reassessment 15 minutes 8–15 minutes
Group G0271 – 2nd annual reassessment 30 minutes 30 minutes

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Behavioral Therapy/Counseling

Category CPT Code(s) Defined Time Expected Time
Alcohol misuse G0443 – Brief face-to-face behavioral counseling for alcohol misuse 15 minutes 8–15 minutes
Depression G0444 – Annual depression screening 5–15 minutes 5–15 minutes
Prevent sexually transmitted diseases G0445 – High intensity behavioral counseling to prevent sexually transmitted diseases 30 minutes 20–30 minutes

May be performed 2x/year
Cardiovascular disease G0446 – Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual 15 minutes 8–15 minutes
Obesity-individual G0447 – Face-to-face behavioral counseling for obesity 15 minutes 8–15 minutes
Obesity-group G0473 – Face-to-face behavioral counseling for obesity, group of 2-10 patients 30 minutes 30 minutes

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Diabetes Self-Management Training

CPT Code(s) Defined Time Expected Time
G0108 – Diabetes outpatient self-management training services, individual 30 minutes 30 minutes
G0109 – Diabetes outpatient self-management training services, group session,2 or more patients 30 minutes 30 minutes


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Revised 9/23/2024