CPT code 97140 is the billing code used for manual therapy techniques. This is a time-based code, meaning it’s billed in 15-minute increments. So, if you’re a physical therapist, occupational therapist, or chiropractor, understanding how to use this code correctly is essential for accurate billing and reimbursement.
This article is a deep dive into CPT code 97140. We’ll cover everything from which professionals can bill it and which manual therapy techniques apply, to essential documentation requirements and tips for maximizing your reimbursement. We’ll also look at some common mistakes people make when using this code.
Understanding CPT Code 97140: What is Manual Therapy?
CPT code 97140 covers manual therapy techniques. In manual therapy, practitioners use their hands to ease pain, reduce swelling, relax muscles, and improve range of motion.
Manual therapy includes techniques like:
- Soft tissue mobilization
- Joint mobilization and manipulation
- Manual lymphatic drainage
- Myofascial release
- Stretching
It’s worth noting the difference between CPT code 97140 and other codes. CPT code 97110, for example, covers therapeutic exercises, while 97140 is reserved for hands-on manual therapy. Also, it’s important to differentiate between therapeutic interventions and techniques used for relaxation.
Manual therapy is often appropriate when a patient’s condition is clinically serious and when manual therapy is likely to improve their physical function.
Time-Based Billing and the 8-Minute Rule
CPT code 97140 is billed using a time-based system, with each unit representing 15 minutes of skilled manual therapy. You’ll calculate the number of units to bill by adding up the time you spent treating each area of the body.
For example, if you spent 20 minutes performing manual therapy, you’d bill one unit of 97140. If the session lasted 40 minutes, you’d bill two units.
The 8-Minute Rule
Medicare uses what’s called the “8-minute rule” to determine how many units to bill. In each 15-minute increment, you have to be in direct contact with the patient for at least 8 minutes to bill for that unit. If there are more than 15 minutes remaining, you have to provide at least 8 minutes of treatment to round up to the next unit.
For example, if you spent 35 minutes providing manual therapy, you’d bill for two units. If you spent 38 minutes, you’d bill for three units.
Who can bill for CPT code 97140?
A number of qualified healthcare providers can bill for CPT code 97140, including:
- Physical therapists (PTs)
- Occupational therapists (OTs)
- Chiropractors
- Physicians
What manual therapy techniques fall under CPT code 97140?
CPT code 97140 covers a wide variety of manual therapy techniques, all geared toward improving a patient’s movement, reducing pain, and restoring function. Here are some of the most common:
- Soft tissue mobilization: Massage and other techniques to release tension in muscles and connective tissues.
- Joint mobilization/manipulation: Skilled passive movements of joints to restore proper mechanics and reduce pain.
- Lymphatic drainage: Gentle techniques to encourage the flow of lymph and reduce swelling.
- Myofascial release: Sustained pressure into restricted fascia to eliminate pain and restore motion.
- Stretching: Lengthening tight muscles to improve flexibility.
- Trigger point therapy: Releasing tight knots in muscles that can cause pain in other areas.
- Transverse friction massage: Deep massage applied across the fibers of a tendon or ligament to promote healing.
- Mobilizations with movement: Combining joint mobilization with active movement by the patient.
- Post-isometric relaxation (PIR): Using muscle contractions to relax tight muscles.
- Strain-counter-strain: Positioning the patient in a way that reduces pain and allows the muscle to relax.
- Active Release Technique (ART): A patented technique that addresses soft tissue restrictions by combining movement and pressure.
- Augmented soft-tissue mobilization: Using tools to assist in soft tissue mobilization.
Medical Necessity and Documentation Requirements
To bill successfully using CPT code 97140, it’s essential to demonstrate medical necessity in your documentation. If you can’t show that the manual therapy you provided was medically necessary, you won’t get paid.
Your documentation should clearly show what conditions warrant manual therapy and how it will improve function for the patient. For instance, you should have specific, measurable goals for how the manual therapy will help the patient achieve greater range of motion or reduce pain. Be sure to document the clinical necessity and clinical indication for each technique you bill for.
Documentation Best Practices
Comprehensive documentation should include these key elements:
- Diagnosis
- Functional limitations
- Treatment goals
- Description of the skilled intervention
- How the patient responded to the treatment
- Plan of care
Be sure to describe the exact manual therapy technique you used (e.g., joint mobilization, myofascial release). Identify the location on the body where you performed the technique and the amount of time you spent on it. Also, include the start and end times for the entire session.
Keep your documentation clear and concise. Document the specific manual therapy techniques you used, the treatment goals you’re trying to achieve, and the patient’s response to each session. Always link the manual therapy you provide to the overall plan of care to demonstrate how it contributes to the patient’s progress.
Modifiers and billing CPT code 97140 with other codes
If you’re billing for manual therapy, it’s important to understand modifiers and how they affect reimbursement.
The role of modifiers
Modifiers such as GP, GO, KX, 59, and 97 are essential for accurate billing. Using the right modifier in the right situation can help ensure you’re properly paid for the services you provided.
For example, modifier 59 is often used when billing CPT codes 97140 and 97012 together.
Billing with other codes
In some cases, you may be able to bill CPT code 97140 along with other codes. CPT codes 97140 and 97012, for instance, can sometimes be billed together if you add modifier 59.
Getting the most reimbursement for CPT code 97140
Therapists sometimes have trouble getting reimbursed for manual therapy using CPT code 97140. Common reasons for this include using the wrong modifiers, miscalculating units, failing to report outcomes, and incomplete documentation.
Here are some tips to help you get the payment you deserve:
- Document outcomes. Be specific about how manual therapy is improving the patient’s condition.
- Show progress. Make sure your notes demonstrate that the patient is moving toward their goals.
- Demonstrate medical necessity. Explain why manual therapy is the best treatment option.
- Describe your technique. Note exactly which manual therapy techniques you used.
- Record patient response. Describe how the patient responded to the treatment.
Summary
CPT code 97140 is a powerful billing tool that can help providers get fairly reimbursed for manual therapy services. But to bill correctly, you need to know the time-based rules, document medical necessity, and follow best practices.
When it comes to CPT code 97140, accuracy is always the best policy.