Is 97140 a timed code?
Asked by: Dr. Leonardo Ebert IV | Last update: May 7, 2025Score: 4.4/5 (23 votes)
Is 97140 a time-based code?
Unlike some CPT codes that are billed per service, CPT code 97140 operates on a time-based system. This means that the duration of the manual therapy session directly determines the number of units you can bill. Medicare follows the 8-minute rule for time-based codes like 97140.
Is manual therapy a timed code?
CPT® code 97140: Manual therapy techniques, 1 or more regions, each 15 minutes (Mobilization/manipulation, manual lymphatic drainage, manual traction) As the authority on the CPT® code set, the AMA is providing the top-searched codes to help remove obstacles and burdens that interfere with patient care.
What are the rules for Medicare 97140?
Time-Based Billing for CPT Code 97140
This code follows the "8-minute rule" generally imposed for Medicare, which says that there must be at least 8 minutes of therapy to bill for a single unit of 97140. The 8-minute rule is a critical aspect of time-based CPT codes like 97140.
Which CPT codes are time-based?
- Electrical stimulation (manual) (97032)
- Ultrasound (97035)
- Gait training (97116)
- Therapeutic exercise (97110)
- Manual therapy (97140)
- Neuromuscular re-education (97112)
- Self-care/home management training (97535)
- Prosthetic training (97761)
Billing 97140 with Your CMT
What is included in time-based coding?
It includes your time before the visit reviewing the chart, the actual face-to-face visit with the patient, and all the time you spend after the visit on documentation, reviewing studies, calling the patient or family, etc.
Is CPT 97035 a timed code?
The services described by these codes require direct one-on-one contact by the provider. Throughout the procedure, the provider is required to maintain visual, verbal, and/or manual contact with the patient. Constant attendance therapies are time-based and billed in 15-minute increments.
What is the difference between 97140 and 97110?
CPT code 97140 is used for skilled manual therapy techniques with no additional activities simultaneously occurring. If therapeutic, resistive, or strengthening exercises are included in combination with manual techniques, these activities fall under CPT code 97110, therapeutic exercise.
Can 97110 and 97140 be billed together?
Since the time for each service is the same, choose either code for 2 units and bill the other for 1 unit. Do not bill 3 units for either one of the codes. Appropriate billing for 40 minutes is for 3 units. Bill 2 units of 97110 and 1 unit of 97140.
How to bill 97140?
Key Requirements for Billing CPT Code 97140
Documenting clinical necessity such as the clinical indication of billed techniques. Describing the exact technique used (joint manipulation, myofascial release, etc.). Identifying the location (shoulder, elbow, hand, etc.), and the time required.
What is the therapy code for 30 minutes?
90832 – Psychotherapy, 30 minutes (16-37 minutes).
What is the difference between timed and untimed CPT codes?
Timed codes are reimbursed based on the time spent working 1:1 with their patient, and include only skilled interventions. Timed codes can be billed multiple times per session, whereas untimed codes can only be billed once per session. Technically, each timed code represents 15 minutes of treatment.
What is an example of 97140?
CPT code 97140 covers many manual therapy techniques. These include soft-tissue techniques, joint mobilization, and more. It also includes muscle energy techniques and functional mobilization. Other techniques like myofascial release and strain-counter-strain are also covered.
Can a massage therapist bill 97140?
Can a massage therapist bill 97140? Yes, a massage therapist can bill 97140, however, it is important to note that CPT code 97124 is more closely associated with massage therapy, so ensure you cite the exact treatment procedures in your claim for coverage.
Does 59 modifier go on 97530 and 97140?
In that document, CMS listed 97140 (manual therapy) and 97530 (therapeutic activities) and explicitly stated that: “Modifier 59 may be reported if the two procedures are performed in distinctly different 15-minute time blocks.
Does Medicare pay for 97140?
Medically necessary hands-on MLD is a covered Medicare service and is coded using CPT® 97140 for manual therapy. There is no Medicare coverage for lymphedema compression bandage application as this is considered to be an unskilled service.
Can you bill 3 units of 97140?
33 minutes of therapeutic exercise, code 97110 7 minutes of manual therapy, code 97140 Total timed code treatment time is 40 minutes. If you look up 40 minutes on the chart, you can bill for a maximum of 3 units (38 to 52 minutes). You can bill 2 units of 97110 and 1 unit of 97140.
Does Aetna cover CPT code 97140?
A few months ago, Aetna released a new policy indicating they will no longer pay for 97140 (manual therapy techniques) when performed on the same date of service as a CMT code (9894x). This even includes billings where the provider appends the -59 modifier (appropriately or inappropriately).
Is 97110 a timed code?
The 97110 CPT code is a timed code, with each unit lasting 15 minutes. Physical therapists must actively work with the client one-on-one during the entire session. This rule, commonly known as the 8-minute rule, is a method employed to calculate how many units of time-based services a patient can bill for Medicare.
When to use modifier 59?
Modifier 59 Distinct Procedural Service indicates that a procedure is separate and distinct from another procedure on the same date of service. Typically, this modifier is applied to a procedure code that is not ordinarily paid separately from the first procedure but should be paid per the specifics of the situation.
Is manual therapy the same as physical therapy?
Manual therapy is a specialty within the field of physical therapy. Traditional physical therapy focuses more on managing and treating the symptoms of the disease process, while manual therapy focuses more on performing biomechanical, tissue-based examination to identify the cause of the disease process.
What is the CPT code 97140?
Specifically, CPT® code 97140 is used to bill for manual therapy techniques. This includes joint mobilization/manipulation, manual lymphatic drainage, and manual traction, applied to one or more regions of the body to alleviate pain, improve mobility, and enhance overall function.
What is the 8-minute rule?
The 8-minute rule was introduced into the rehab therapy billing process in the year 2000 and is utilized by outpatient physical therapy services, allowing a physical therapy practitioner to bill for services as long as they see their patient for at least eight minutes, which would serve as one unit of therapeutic ...