Common CPT codes for massage therapists.

So you want to start billing insurance companies. Here is some helpful information that I have learned
over the past 14 years of billing insurance companies in Washington State. I have taken classes in most
of the 50 states and have heard many different rules that apply in some states and not others.
This is not intended to answer all your questions by no means. It is just a starting point. In most states this
applies to Labor and Industry and Auto Insurance Claims only.
Most commonly used CPT coeds for Massage Therapist:

97010 Hot and Cold pack Therapy (Hydro Therapy)

97112 Neuromuscular Therapy
97124 Massage Therapy (Basic Swedish Massge)
97140 Manual Therapy (Advanced Massgae Therapy Techniques)
Mixing and matching these codes can get your claim or part of your claim rejected depending on the
insurance company and the state you are in.
Now the most important thing to note is that each of these codes is time sensitive and 1 unit = 15
minutes. 97010 can only be used 1 time per day. If a chiropractor, physical therapist or even a doctor has
already used this code then you can not. For this reason is best to have your appointments set up on
different days from other providers.
The following 2 codes can be used if the doctor in charge gives that privilege by writing something such
as "evaluate and treat" on the prescription. If this is written on the prescription/ referral then the Doctor
has given you use of his license to evaluate the patient. This would mean that you have gained the
Doctors trust. Make sure that you dont lose that trust. Write a complete and thorough evaluation and if
you dont feel confident in doing so then dont bill for it.
97001 Office Evaluation (1st Appointment only) This code is not time sensitive set your billing according to
the time and detail of the evaluation skills you have.
97002 Office Re-evaluation with new referral/prescription

Two more things that a massage therapist can charge for is:
1. Clerical fees (Medical Records)
2. Interest for bills outstanding more than 30 days. How much depends on your state.
Now having giving you the basic information of different codes and what you can charge for be aware that
this is just a list of the usual codes listed. The CPT codebook does say that no code belongs to any
category of provider. You must be competent and within the scope of your licensure. The scope of your
licensure varies from state to state.
Note all Codes starting with 99 were written with the intent of being used by Doctors. All codes starting
with 97 were written with the intent of being used by physical therapist. Remember the codes I listed
above all start with 97 but massage therapist werent in existence at the time the codes were written so
you need to look at the detailed code description and make sure that the code description fits within the
scope of the licensure for your state.
The last piece of advice I can give you is make sure that you dont up code. Another words if you dont
have the training and competencies in one of the more advanced techniques dont bills for it. If you did
this would be up coding or fraud.
Good luck. I hope this helped cut through some of the red tape and answer some of the more common
questions asked about billing insurance companies. Watch my site I will be writing more articles to help
those starting out navigate the billing process.
Peter Spairring L.M.P.
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