CPT Codes for Massage Theapists

4.      Current Procedural Techniques (CPT codes), International Classification of Disease (ICD-9 codes)

CPT codes or Current Procedural Techniques codes and ICD-9 or International Classification of Disease codes (9^th edition) are determined by the American Medical Association (AMA).  New codes are created every 10 years. They will often make the difference in how, when and what you will be paid.

The most common codes used by massage therapists are codes that are often used by physical therapists as the massage profession does not have their own category (yet!).  There really are not any regulations as to who can use the codes as long as the health care provider is properly trained and licensed.  (ie. A physician can do massage and bill 97124 as long as they have training in massage).  If another health care practitioner bills for the same code on the same date, you may not be paid (concurrent care).  (If a chiropractor sees the patient on the same day as you and bills for 1 unit of 97124 and you bill 4 units of 97124, you will not be paid for 1 unit if that goes over the allowable number of units.)

 

97124- Therapeutic procedure, one or more areas, each 15 minutes: massage including effleruage, petrissage and/or tapotement (stroking, compression, percussion; therapeutic massage.

97140- Manual Therapy techniques: mobilization, manipulation, manual lymphatic drainage, manual traction, one or more regions, each 15 minutes.

97122- Therapeutic procedure, one or more areas, each 15 minutes: Neuromuscular re-education of movement, balance, coordination, kinesthetic sense, posture and proprioception. (this would include Proprioceptive Neuromuscular Facilitation (PNF), Feldenkrais but not St. John’s Neuromuscular Therapy.)

97010 –Hot/cold packs

97250 – myofascial release/soft tissue mobilization; This code has supposedly been discontinued, but may be still recognized by some L&I or WC.

There is much controversy over which codes to use.  Often an insurance company will pay more for different codes. Even if a company says that you can bill a certain code, it is your responsibility to make sure that you are legally able to use that code.  How one does that is a complete mystery.  Even among experts in the profession there are many “opinions” as to what are the proper codes.  Some say 97124 is only for “relaxation massage”.  There is one insurance company here that will pay for that code only (not 97140 or any other code).  There is also much controversy over what relaxation massage is compared to medical massage. 

 

Some miscellaneous codes that are often questionable at this time are:

97018 – paraffin bath

97022- whirlpool

97026 -infrared

97122- traction, manual

97530- therapeutic activities, each 15 minutes

97110- therapeutic exercise, each 15 minutes

 

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