Medicaid TBI - Allied Health TBI - OT

Service Codes & Descriptions

• 92592 - hearing aid check monaural
• 92595 - electroacoustic evaluation for hearing aid binaura
• 29075 - application of forearm cast
• 29085 - application hand/wrist cast
• 29105 - application long arm splint
• 29125 - application forearm splint
• 29130 - application finger splint static
• 29131 - application finger splint dynamic
• 29240 - strapping of shoulder
• 29260 - strapping of elbow or wrist
• 29280 - strapping;
• 29405 - application short leg cast
• 29425 - application short leg cast
• 29505 - application long leg splint
• 29515 - application lower leg splint
• 29530 - strapping;
• 29540 - strapping;
• 36908 - STENT PLMT CTR DIALYSIS SEG
• 92507 - treatment of speech, language, voice, communication, and/ or auditory
• 92507 GT- treatment of speech, language, voice, communication, and/or auditory telehealth
• 92507 GT CR- treatment of speech, language, voice, communication, and/ or auditory
• 92508 - treatment of speech, language, voice, communication, and/ or auditory
• 92521 - EVALUATION OF SPEECH FLUENCY
• 92521- EVALUATION OF SPEECH FLUENCY telehealth
• 92521 GT CR- EVALUATION OF SPEECH FLUENCY
• 92522 - EVALUATE SPEECH PRODUCTION
• 92522 GT- Evaluate Speech Production
• 92522 GT CR- EVALUATE SPEECH PRODUCTION
• 92523 - SPEECH SOUND LANG COMPREHEN
• 92523 GT- Speech Sound Language Comprehension telehealth
• 92523 GT CR- SPEECH SOUND LANG COMPREHEN
• 92524 - BEHAVRAL QUALIT ANALYS VOICE
• 92524 GT- Behavioral Quality Analysis Voice telehealth
• 92524 GT CR- BEHAVRAL QUALIT ANALYS VOICE
• 92526 - treatment of swallowing dysfunction and/or oral function for feeding
• 92526 GT- treatment of swallowing dysfunction and/or oral function for feeding (telehealth)
• 92526 GT CR- treatment of swallowing dysfunction and/or oral function for feeding
• 92550 - Tympanometry and reflex threshold measurements (Do not report 92550 in conjunction with 92567, 92568)
• 92551 - hearing test
• 92552 - hearing test
• 92553 - hearing test
• 92555 - speech audiometry threshold;
• 92556 - speech audiometry threshold; with speech recognition
• 92557 - comprehensive audiometry threshold evaluation and speech recognition (92553 and
• 92567 - tympanometry
• 92568 - acoustic reflex testing
• 92569 - acoustic reflex decay test
• 92570 - Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing. (Do not report 92570 in conjunction with 92567, 92568)
• 92571 - special hearing test
• 92572 - special hearing test
• 92576 - special hearing test
• 92579 - visual reinforcement audiometry (vra)
• 92582 - special hearing test
• 92583 - special hearing test
• 92585 - auditory evoked potentials for evoked response audiometry and/or testing of the
• 92587 - evoked otoacoustic emissions; limited (single stimulus level, either transient
• 92588 - evoked otoacoustic emissions; comprehensive or diagnostic evaluation
• 92590 - hearing aid examination and selection monaural
• 92591 - hearing aid exam and selection binaural
• 92593 - hearing aid check binaural
• 92594 - BEHAVRAL QUALIT ANALYS VOICE
• 92607 - eval for prescription for speech generating & alt. comm. device - face to face
• 92607 GT- Eval for prescription for speech generating and alt. comm device face-to-face telehealth
• 92607 GT CR- eval for prescription for speech generating & alt. comm. device - face to face
• 92608 - each additional 30 minutes (use in conjunction with 92607)
• 92608 GT- each additional 30 min (used in conjunction with 92607) telehealth
• 92608 GT CR- each additional 30 minutes (use in conjunction with 92607)
• 92609 - therapeutic svcs for use of speech generating device including prog. & modif.
• 92609 GT- therapeutic svces for use of speech generating device including program & mod
• 92609 GT CR- therapeutic svcs for use of speech generating device including prog. & modif.
• 92610 - eval of swallowing and oral function for feeding
• 92612 - endoscopic study of swallowing
• 92620 - evaluation of central auditory function, with report; initial 60 minutes
• 92621 - evaluation of central auditory function, with report; each additional 15 minutes
• 92626 - evaluation of auditory rehabilitation status; first hour
• 92627 - evaluation of auditory rehabilitation status; each additional 15 minutes (li
• 92630 Auditory Rehab Pre Lingual
• 92630 GT CRAuditory Rehab Pre Lingual
• 92633 Auditory Rehab Post Lingual
• 92633 GT CRAuditory Rehab Post Lingual
• 92640 - AUD BRAINSTEM IMPLT PROGRAMG
• 95831 - muscle testing, manual (separate procedure) with report; extremity (excluding
• 95832 - muscle testing hand
• 95833 - muscle testing total evaluation of body excluding
• 95834 - body muscle evaluation
• 96125 - standardized cognitive performance testing (eg, ross information processing assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patient and time interpreting these test result
• 96125 GT CR- standardized cognitive performance testing (eg, ross information processing assessment) per hour of a qualified health care professional's time, both face-to-face time administering tests to the patient and time interpreting these test r
• 97010 - application of a modality to one or more areas; hot or cold packs
• 97012 - physical med treatment one area traction
• 97016 - physical med treatment vasopneumatic devices
• 97018 - physical med treatment paraffin bath
• 97022 - physical medicine treatment whirlpool
• 97024 - physical medicine treatment diathermy
• 97026 - physical medicine treatment infrared
• 97028 - physical medicine treatment one area ultraviolet
• 97032 - application of a modality to one or more areas;
• 97034 - application of a modality to one or more areas;
• 97035 - application of a modality to one or more areas;
• 97036 - application of a modality to one or more areas;
• 97110 - therapeutic procedure, one or more areas, each 15 minutes; therapeutic
• 97110 GT CR- therapeutic procedure, one or more areas, each 15 minutes; therapeutic
• 97112 - therapeutic procedure, one or more areas, each 15 minutes; neuromuscular
• 97112 GT CR- therapeutic procedure, one or more areas, each 15 minutes; neuromuscular
• 97116 - therapeutic procedure, one or more areas, each 15 minutes; gait training
• 97116 GT CR- therapeutic procedure, one or more areas, each 15 minutes; gait training
• 97124 - therapeutic procedure, one or more areas, each 15 minutes; massage, including
• 97140 - manual therapy techniques
• 97161 - PT EVAL LOW COMPLEX 20 MIN
• 97161 GT CR- PT EVAL LOW COMPLEX 20 MIN
• 97162 - PT EVAL MOD COMPLEX 30 MIN
• 97162 GT CR- PT EVAL MOD COMPLEX 30 MIN
• 97163 - PT EVAL HIGH COMPLEX 45 MIN
• 97164 - PT RE-EVAL EST PLAN CARE
• 97164 GT CR- PT RE-EVAL EST PLAN CARE
• 97165 - OT EVAL LOW COMPLEX 30 MIN
• 97165 GT CR- OT EVAL LOW COMPLEX 30 MIN
• 97166 - OT EVAL MOD COMPLEX 45 MIN
• 97166 GT CR- OT EVAL MOD COMPLEX 45 MIN
• 97167 - OT EVAL HIGH COMPLEX 60 MIN
• 97167 GT CR- OT EVAL HIGH COMPLEX 60 MIN
• 97168 - OT RE-EVAL EST PLAN CARE
• 97168 GT CR- OT RE-EVAL EST PLAN CARE
• 97530 - therapeutic activities, direct (one on one) patient contact by the provider
• 97530 GT CR- therapeutic activities, direct (one on one) patient contact by the provider
• 97535 - self-care/home management training (eg, activities of daily living (adl) and
• 97535 GT CR- self-care/home management training (eg, activities of daily living (adl) and
• 97613 - PT EVAL HIGH COMPLEX 45 MIN
• 97750 - physical performance test or measurement (eg, musculoskeletal,
• 97750 GT CR- physical performance test or measurement (eg, musculoskeletal,
• 97760 - orthotic(s) management and training (including assessment and fitting when n
• 97761 - prosthetic training, upper and/or lower extremity(s), each 15 minutes
• 97762 - checkout for orthotic/prosthetic use, established patient, each 15 minutes
• 97763 - ORTHC/PROSTC MGMT SBSQ ENC
• 97763 GT CR- ORTHC/PROSTC MGMT SBSQ ENC