PIP Reimbursement for Functional Movement Screening (FMS) - CPT S9090

PIP Coverage for CPT S9090 – Functional Movement Screen (FMS)

Yes. Personal Injury Protection (PIP) in no‑fault auto insurance states typically reimburses CPT code S9090 for Functional Movement Screening when:

• Performed by a licensed provider (PT, DC, MD, DO) within scope.
• Medically necessary to assess movement deficits related to the motor‑vehicle accident.
• Documented with objective findings, treatment plan, and progress notes.

What FMS Entails

Seven fundamental movement patterns scored 0–3:

1. Deep squat
2. Hurdle step
3. In‑line lunge
4. Shoulder mobility
5. Active straight‑leg raise
6. Trunk stability push‑up
7. Rotary stability

Composite score ≤14 suggests elevated injury risk; asymmetries guide targeted intervention.

Billing Tips

• Use S9090 (or 97110/97112/97116 if FMS bundled into therapeutic exercise/neuromuscular re‑ed).
• Include ICD‑10 codes linking to accident‑related diagnoses (e.g., S39.012, S13.4).
• Attach FMS score sheet and clinical rationale to claim.
• Verify state‑specific PIP fee schedules and pre‑authorization requirements.