Hi,
97001 is the cpt code specifically for an initial physical therapy evaluation to evaluate the client’s condition and establishing the plan of care. An E&M code is for the evaluation and management of a medical condition, a medical exam that must meet certain key components. A physical therapist should not be using E&M codes for their initial evaluation since there is a more specific cpt code to indicate the PT initial eval.
As for the 97002, or re-eval, the frequency depends on each individual insurance carriers. Some state you can only do a re-eval once per year. Others have different criteria. There is no universal rule.
For group therapy, I am not aware of any restrictions specifically due to age. Each insurance carrier has their own guidelines (sorry if I sound like a broken record
) but usually PT is covered if it is ordered by a physician for a covered medical condition.
Hope that helps you out.
Michele
