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The Billing & Documentation Cheat Sheet
Game-based occupational therapy that survives an audit: the CPT codes and the two documentation rules that decide whether a claim gets paid.
- The codes you can bill today, in plain terms
- Two rules that make or break the claim
- Skilled, audit-ready note examples + a 30-second checklist
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Games and play are already inside OT's licensed scope: AOTA's OTPF-4 lists play and leisure among the core occupation categories. The reimbursement question isn't whether game-based therapy is billable. It's whether the session and the note meet the same standard as any other skilled OT service. Here's the map.
The CPT codes you can use today
97530
Therapeutic activities
Dynamic, functional activity to improve performance. The primary code for game-based functional work. Billed in 15-minute direct-contact units.
97129 / 97130
Cognitive function intervention
Attention, memory, reasoning, executive function, problem-solving. Board, video, and tabletop play targeting cognition bill here.
98975–98981
Remote therapeutic monitoring
Covers OT-authorized digital home programs. Device-supply codes have extra requirements, so check code-by-code.
0770T
VR technology add-on (Category III)
Stacks on core OT codes when VR is used as an adjunct. A garnish, not the meal: a temporary code with uncertain payer uptake.
The two rules that make or break your claim
1. Timed codes require direct, one-on-one contact. The clock runs only while you are actively engaged with the client. A client playing independently while you watch from across the room isn't billable time under the timed codes.
2. Your note names the skilled component, not just the game. Write what you, the clinician, did: grading the task, cueing a specific motor or cognitive strategy, adapting the setup, and measuring functional change against a goal.
The full sheet turns these into side-by-side note examples (under-documented vs. skilled & audit-ready) and a 30-second documentation checklist you can keep at your desk. Grab it here →
This is general educational information, not billing, coding, or legal advice for a specific claim. Payer policies vary and should be confirmed before submission.