Direct/Indirect and Timed/Untimed CPT Codes

Created by Misty Ahmad, Modified on Mon, 23 Sep, 2024 at 5:13 PM by Jen Sommers

Practice Intel:

Direct/Indirect & Timed/Untimed Definitions

Direct vs Indirect

Direct treatment refers to the time spent by the therapist providing skilled therapy services directly to the patient, such as manual therapy, therapeutic exercises, and neuromuscular re-education.

Indirect treatment refers to the time spent by the therapist on activities that are not directly related to the patient's care, but are necessary for the provision of skilled therapy services, such as modalities.

Timed vs Untimed

Timed codes refer to the services that are provided for a specific amount of time, such as therapeutic exercises or manual therapy, and are billed based on the total time spent providing the service. The time spent providing the service is documented in minutes, and the total number of minutes is divided by the number of minutes in the billing code's time increment (which depends on if your clinic bills by the "Total Minute Rule or "AMA Rule") to determine the number of units to be billed. See our Coding Rule Definition Support Document for more information.

Untimed codes refer to the services that are not provided for a specific amount of time, such as evaluation and management services or interventions that are not timed-based. These services are billed based on the number of units provided, which is determined by the provider's documentation of the service. For example, if a therapist treats a patient with electrical stimulation, they would bill one unit of the corresponding untimed CPT code, regardless of the amount of time spend providing the service.

CPT Codes - Supervision and Time Class

CPT Codes	Hierarchy Names	CPT Codes Examples	Supervision	Time Class
10004 - 69990	Surgery (mainly casting, strapping codes)	20560 - Needle insertions without injections; 1 or 2 muscles 20561 - Needle insertions without injections; 3 or more muscles 29240 - Shoulder Strapping 29520 - Strapping; Hip 29530 - Strapping; knee	direct	untimed
90901 - 90913 except 90912, 90913	Biofeedback Services and Procedures	90901 - Biofeedback train any meth	direct	untimed
90912, 90913	Biofeedback Services and Procedures	90912 - Bfb training 1st 15 min 90913 - Bfb training ea addl 15 min	direct	timed
92507, 92521, 92522, 92523, 92524, 92526	Special Otorhinolaryngologic Services and Procedures	92507 - Speech/hearing therapy 92523 - Speech sound lang comprehen 92526 - Oral function therapy	direct	untimed
97001 - 97006	Physical Medicine & Rehab - Older Eval, Re-Eval Codes	97001 - PT EVALUATION 97002 - PT RE-EVALUATION 97003 - OT EVALUATION 97004 - OT RE-EVALUATION	direct	untimed
97010 - 97028	Physical Medicine & Rehab - Indirect Modalities	97010 - Hot or cold packs therapy	indirect	untimed
97032 - 97039	Physical Medicine & Rehab - Direct Modalities	97035 - Ultrasound therapy	direct	untimed
97161 - 97172	Physical Medicine & Rehab - Eval, Re-Eval	97161 - Pt eval low complex 97162 - Pt eval mod complex 97163 - Pt eval high complex 97164 - Pt re-eval est plan care	direct	untimed
97150 - 97150		97150 - Group therapeutic procedures	indirect	untimed
97110 - 97544, 97799	Physical Medicine & Rehab - Procedures	97110 - Therapeutic exercises 97112 - Neuromuscular reeducation 97530 - Therapeutic activities	direct	timed
97545 - 97546	Physical Medicine & Rehab - Work Hardening	97545 - Work hardening 97546 - Work hardening add-on	direct	timed
97597 - 97610	Active Wound Care Management	97597 - RMVL devital tis 20 cm/< 97605 - Neg press wound tx < 50 cm	direct	untimed
97750 - 97755	Physical Medicine & Rehab - Tests and Measurements	97750 - Physical performance test 97755 - Assistive technology assess	direct	timed
97760 - 97763	Orthotic Management & Training	97760 - Orthotic mgmt & train 1st enc	direct	timed
97802 - 97814	Medical Nutrition, Acupuncture	97802 - Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes	direct	timed
98925 - 98943	Osteopathic Manipulative Treatment		direct	timed
98960 - 98962	Edu & Training for Patient Self-Management	98960 - Self-mgmt educ & train 1 pt	direct	untimed
98966 - 98981	Non-Face-to-Face Non-physician Services		direct	timed
99082 - 99082		99082 - Unusual physician travel	direct	timed
99000 - 99091	Special Services, Procedures, Reports	99072 - COVID-19 Supplies and Activities	indirect	untimed
A2001-A2021	Matrix for Wound Management (Placental, Equine, Synthetic)		indirect	untimed
A4100-A4100	Skin Substitute Device		indirect	untimed
E0100-E8002	Durable Medical Equipment		indirect	untimed
G0008-G9987	Procedures / Professional Services	G0281 - Elec stim unattended for press G0282 - EStim Unattended Other Wounds G0283 - Elec stim other than wound G2250 - Remot img sub by pt, non e/m G2251 - Brief chkin, 5-10, non-e/m G8420 - Documented calculated BMI within normal parameters G8427 - Current Medications with Name, Dosages, Frequency, and Route Documented	indirect	untimed
K0001-K0900	Durable medical equipment (DME) Medicare administrative contractors (MACs)		indirect	untimed
L0112-L4631	Orthotic Procedures and services	L3702 - Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment L3808 - Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment L3913 - Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment L3933 - Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment	direct	untimed
L5000-L9900	Prosthetic Procedures		direct	untimed
M0001-M0005	MIPS Value Pathways		indirect	untimed
S0012-S9999	Temporary National Codes (Non-Medicare)	S3702 - Elbow Orthosis Static S3808 - Forearm Based Static S3906 - Custom WHO S3913 - Self Pay Hand Based Static S3933 - Finger Based static	indirect	untimed
S0012-S9999	Temporary National Codes (Non-Medicare)	S8948 - Low Level Laser Light Therapy (Attended)	indirect	untimed
T1000-T5999	National Codes Established for State Medicaid Agencies	T9999 - Treatment Follow up	indirect	untimed
U0001-U0005	Coronavirus Diagnostic Panel		indirect	untimed
V2020-V2799	Vision Services		indirect	untimed
V5008-V5364	Hearing Services		indirect	untimed
X3900 - X3902	X Codes (Medi Cal)	X3900 - Single modality to one area - initial 30 minutes X3902 - Single modality to one area each additional 15 minutes	indirect	untimed
X3904 - X3906	X Codes (Medi Cal)	X3904 - Single procedure to one area initial 30 minutes X3906 - Single procedure to one area each additional 15 minutes	direct	untimed
X3908 - X3910	X Codes (Medi Cal)	X3908 - Combination of any modalities and procedures (one or more areas) initial 30 minutes X3910 - Combination of any modalities and procedures (one or more areas) each additional 15 minutes	direct	untimed
X3916 - X7005	X Codes (Medi Cal)	X3920 - Eval/Re-Eval 30 mins X3922 - Eval/Re-Eval additional 15 mins	direct	untimed