WSI requires billed physical therapy time to be the amount of skilled time spent with the injured employee in treatment. This includes billing for the use of exercise machines.
A therapeutic exercise code (i.e., 97110) billed for the use of an exercise machine is only eligible for reimbursement if accompanied by medical documentation that supports the expertise and knowledge of the physical therapist was necessary and provided.
To demonstrate services are at a level of skilled care, documentation needs to clearly indicate the therapist’s unique professional contribution to the service. The following are clarifications to the skilled time billing requirement regarding exercise machines:
- It is acceptable to bill for time on an exercise machine (e.g., treadmill, stationary bike, NuStep and upper body ergometer) if the service is skilled. Documentation should note the therapist was present and the reasons they were present. Examples of this include:
- Provided cues for posture, gait, proper technique, or breathing techniques.
- Provided physical assistance for safety, stability, or range of motion.
- Monitored the injured employee’s vitals such as heart rate, blood pressure, or rate of perceived exertion.
- Modified speed, resistance, or cadence based on the injured employee response.
- Regularly assessed and adjusted the speed, resistance, incline, time, or distance throughout the episode of care.
- Provided cues for posture, gait, proper technique, or breathing techniques.
- Supervision of an injured employee who is exercising independently is not a skilled service and therefore not billable.
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