For clinicians
Billing & documentation
Game-based therapy is billable today under standard codes, because billing attaches to the therapist's skilled service. This page collects the codes, the constraints, and the documentation habits in one place, each linked to its primary source.
Billing specifics on this page reflect occupational therapy practice. Recreational therapists, physical therapists, and speech-language pathologists: your codes and settings differ, and discipline-specific guidance is coming.
Two Medicare constraints, and where your skill shows
Billing attaches to the therapist's skilled service: the skilled work you already provide and document. Two things make that skilled service clear and defensible, and both play directly to a trained clinician's strengths:
- Direct, one-on-one contact. Timed codes reward hands-on contact time: you are actively grading, cueing, and adjusting the game throughout the session. That active, face-to-face skilled time is what you bill.
- Documented skilled components. Your note captures the clinical reasoning: the goal, the grading decisions, the cueing, and the client's response. Showing that reasoning is what distinguishes skilled therapy from recreation, and it is a habit good clinicians already have.
Source: CMS Billing & Coding Article A57067 ↗ (contractor-specific rules vary by MAC)
The billing rails already exist
Standard CPT / RTM codes clinicians use every day. Each links to its primary source.
Dynamic activities to improve functional performance; direct one-on-one, 15-minute units. On AOTA’s 2026 frequently-used OT code list.
Primary source ↗Attention, memory, reasoning, executive function; 97130 is the 15-minute add-on. Usable by OT practitioners since 2020.
Primary source ↗Added to the Medicare therapy code list Jan 1, 2022; OTs explicitly authorized (GO modifier).
Primary source ↗Effective Jan 1, 2023; reports VR technology as an adjunct to therapy. Temporary code. Payer coverage uncertain.
Primary source ↗Codes are reported for the practitioner's skilled service time. This is educational information, not billing or coding advice. Verify current rules with your payer and MAC.
Take it with you
The one-page cheat sheet puts the codes and the two claim rules in your pocket, free.