Does not require prior authorization.
Functional capacity evaluations are considered vocational/work related in nature and are not covered.
Functional capacity evaluation (FCE) or functional capacity assessment (FCA) is a systematic, comprehensive, objective measurement of an individual's maximal work abilities. Functional capacity evaluations are done to determine an individual's ability to perform work-related functions.
If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.
97750 - Physical performance test or measurement (eg, musculoskeletal, functional capacity), with
written report, each 15 minutes
This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.