How to Bill CPT 97165 in Specialty Medical Practices

When to Use CPT Code 97165

CPT 97165 is commonly billed in specialty practices for diagnostic testing, therapy services, or interventional care.

• •Specialty use: Chiropractic, therapy services, behavioral health, audiology, or pain management
• •Service type: Diagnostic, therapeutic, or procedural service
• •Who bills it: Specialists and qualified healthcare providers

Common scenarios:

• •Therapy and rehabilitation sessions
• •Neurocognitive or psychological testing
• •Chiropractic manipulation
• •Image-guided pain procedures

Insurance Verification Tips for CPT 97165

1. •Verify visit limits and therapy caps.
2. •Confirm authorization requirements.
3. •Apply time-based rules correctly.
4. •Ensure documentation supports medical necessity.

Example Case of CPT 97165

A specialist provides a service appropriate to their discipline and documents the encounter thoroughly.
The service is billed as one unit of CPT 97165.