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PT & OT Re-evaluation Reimbursement This policy has been developed to describe the criteria that Optum uses to conduct utilization review (UR).Insert information regarding functional status of any area addressed by your therapy during the prior year. Include information regarding the assessment Therapy evaluation, re-evaluation, and formal testing codes can only be billed when the medical record supports the completion of a medically necessary Retrieved from ​apta.org/Guide/​. Accessed [September 10, 2018]. Connecticut Department of Public Health. Physical Therapist Licensure - Practice Act The new evaluation codes reflect three levels of patient presentation: low-complexity (97161), moderate-complexity (97162), and high-complexity (97163), and Medicare outpatient rehabilitation therapy documentation requirements Medicare covers outpatient PT, OT, and SLP services when:.