2025 CPT code 97129
(Active) Effective Date: N/A Revision Date: N/A Rehabilitation - Therapeutic Interventions Medicine Services and Procedures > Physical Medicine and Rehabilitation Evaluations Feed
Therapeutic interventions focusing on cognitive function (attention, memory, reasoning, executive function, problem-solving, pragmatic functioning) and compensatory strategies for activity management (time/schedule management, task initiation/organization/sequencing); initial 15 minutes of direct (one-on-one) patient contact.
Modifiers 59 (distinct procedural service), 76 (repeat procedure by the same physician), 77 (repeat procedure by another physician), and 79 (unrelated procedure) may be applicable depending on the circumstances.Consult appropriate coding guidelines and payer specific rules for correct modifier application.
Medical necessity is established by the presence of cognitive impairment impacting the patient's ability to perform activities of daily living or participate in social interactions.The therapy must be considered medically necessary and appropriate for the patient's condition, according to established guidelines.
The clinical responsibility involves direct one-on-one patient contact by a physician or other qualified healthcare professional to provide cognitive, executive function, and compensatory therapeutic interventions.
- Medicine Services and Procedures > Physical Medicine and Rehabilitation Evaluations
- Physical Medicine and Rehabilitation Evaluations
In simple words: The doctor or therapist works directly with the patient for 15 minutes to improve thinking, remembering, problem-solving, and planning skills. They also help the patient develop strategies to manage daily tasks and schedules.If the session lasts longer than 15 minutes, additional codes may be needed.
This CPT code, 97129, represents the initial 15 minutes of direct one-on-one contact between a healthcare provider and a patient.The focus of this therapeutic intervention is on improving cognitive functions, such as attention, memory, reasoning, executive function, problem-solving, and pragmatic functioning.The provider also assists the patient in developing compensatory strategies to manage the performance of daily activities, including time and schedule management, and the initiation, organization, and sequencing of tasks.For each additional 15-minute interval of one-on-one contact providing similar interventions, code 97130 should be reported in addition to 97129.
Example 1: A patient with a traumatic brain injury is undergoing rehabilitation.The therapist uses code 97129 to document the initial 15 minutes of cognitive retraining, focusing on memory and attention., A patient diagnosed with ADHD is receiving therapy to improve organizational and time management skills. The therapist uses code 97129 for the initial 15 minutes of one-on-one session focusing on executive function training., An elderly patient experiencing cognitive decline due to dementia receives therapy to enhance their daily functioning. The therapist uses code 97129 to document the first 15 minutes of the session addressing compensatory strategies for activities of daily living.
Detailed documentation should include the patient's cognitive deficits, goals of therapy, specific interventions used, and the patient's response to treatment.Time spent on each intervention should be clearly documented.Progress notes should reflect the overall time spent in one-on-one direct patient contact.
** This code is used to report one-on-one therapy. Group therapy is reported using different codes.Always ensure that all documentation is complete and supports medical necessity.
- Revenue Code: M5D (SPECIALIST - OTHER)
- RVU: Information not available in provided source. Consult current fee schedules and RVU databases for up-to-date values.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not available in the provided source. Consult historical fee schedules and databases for up-to-date values.
- Specialties:Neurology, Physical Medicine and Rehabilitation, Occupational Therapy, Speech-Language Pathology, Psychology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Rehabilitation Facility, Skilled Nursing Facility