Physical Therapy - Therapeutic Exercise
CPT Code: 97110
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Check My Bill for Physical Therapy - Therapeutic Exercise →Understanding the cost of Physical Therapy - Therapeutic Exercise
What does the Medicare rate mean?
The Medicare rate of $32.81 is the amount the federal government pays providers for CPT 97110under the Medicare Physician Fee Schedule. It’s the most widely published benchmark for what a procedure "should" cost and is used as a reference point by commercial insurers when negotiating their own rates.
What do commercial insurers pay?
Commercial insurers (Blue Cross, Aetna, UnitedHealth, etc.) negotiate rates independently with each provider network. As a rule of thumb, these rates fall in the $39.37 – $65.62 range for Physical Therapy - Therapeutic Exercise — roughly 1.2 to 2 times Medicare. If you were billed significantly more, the excess may be negotiable.
What if I was billed more than the commercial range?
Bills above the typical commercial range are common, especially for uninsured or out-of-network patients who receive chargemaster (list) prices. You have several options:
- Ask for the Medicare rate or self-pay discount — many providers will accept this immediately.
- Request an itemized bill — billing errors are common and can account for hundreds or thousands of dollars.
- Appeal if you have insurance — if the procedure was denied or you were billed out-of-network, you have the right to appeal.
- Ask about financial assistance — nonprofit hospitals are required by law to offer charity care programs.
How physical therapy charges like this are billed
Physical therapy is billed in timed units governed by Medicare's 8-minute rule, which determines how many units a session can support based on the minutes of direct one-on-one treatment. Overbilled units and plan visit caps are the two recurring cost issues for PT.
Common billing problems with physical therapy charges
More timed units than the session minutes support
Under the 8-minute rule, the number of billable timed units is tied to total treatment minutes. A session billed for more units than the documented time allows is a common and checkable error.
Visit caps and authorization limits
Many plans limit covered PT visits per year or require re-authorization after a set number. Denials beyond a cap can sometimes be appealed with documentation of medical necessity.
Group therapy billed as one-on-one
One-on-one timed codes pay more than group therapy. If your session was partly group-based, confirm it was billed correctly.
How to push back on this charge
Ask for the treatment time log and compare it against the units billed. For cap denials, request the medical-necessity criteria and file an appeal if continued therapy is clinically justified.
Frequently asked questions
How much does Physical Therapy - Therapeutic Exercise cost without insurance?
Without insurance, you may be billed the chargemaster (list) rate, which can be 3–10× the Medicare rate. For Physical Therapy - Therapeutic Exercise, that could mean a bill of $98.43–$164.05 or more. Always ask for the self-pay or cash-pay rate before accepting the listed price — providers often offer significant discounts.
What is CPT code 97110?
CPT 97110 is the Current Procedural Terminology code assigned to Physical Therapy - Therapeutic Exercise. It’s used by providers, insurers, and Medicare to identify and bill for this specific service. You’ll find it on your Explanation of Benefits (EOB) or itemized bill.
Can I negotiate the cost of Physical Therapy - Therapeutic Exercise?
Yes. Negotiating medical bills is common and often successful. Referencing the Medicare rate of $32.81 gives you a credible, federally published benchmark to anchor the conversation. Many providers will accept 1–1.5× Medicare as a cash settlement.