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CPT Code 97014 Guide for Chiropractors and Physical Therapists
If you work in chiropractic care or physical therapy, you may have heard of CPT code 97014. This code is used for unattended electrical muscle stimulation (EMS) therapy, a common treatment for pain relief and muscle rehabilitation.
In this guide, we’ll explain everything you need to know about CPT 97014, including its definition, usage, reimbursement considerations, and Medicare guidelines.
What is CPT Code 97014?
CPT code 97014 refers to “Electrical Stimulation (Unattended).” This means the treatment is applied without constant supervision by the provider. This therapy helps reduce pain, improve circulation, and promote healing by delivering low-level electrical currents to targeted muscle areas.
Key Facts about CPT 97014
- Used in chiropractic and physical therapy settings for unattended electrical muscle stimulation.
- Not reimbursed by Medicare—providers must use the alternative HCPCS code G0283 for Medicare patients.
- Requires proper documentation for successful reimbursement from private insurers.
- Billed once per session regardless of the duration or number of applications.
Types of Electrical Stimulation in Therapy
Electrical stimulation therapy includes several techniques, each serving different purposes:
- Electrical Muscle Stimulation (EMS)
Used for muscle strengthening, pain management, and rehabilitation.
- High Voltage Pulsed Current (HVPC)
Also called electrogalvanic stimulation, this helps with pain relief and blood circulation.
- Neuromuscular Electrical Stimulation (NMES)
Targets nerves and muscles to improve strength and range of motion.
- Functional Electrical Stimulation (FES)
Assists individuals with paralysis or muscle weakness to regain movement.
- Transcutaneous Electrical Nerve Stimulation (TENS)
A common therapy for pain relief that disrupts pain signals sent to the brain.
Billing & Reimbursement for CPT 97014
Correct billing ensures smooth reimbursement. Since Medicare does not cover CPT 97014, providers must use G0283 when billing Medicare.
For private insurance, it’s important to check the insurer’s policy, as some follow specific guidelines or reductions when billing multiple procedures.
Example Billing Codes by Practice Type
Practice Type | Common Billing Codes |
Chiropractic | 97014, G0283 (Medicare) |
Physical Therapy | 97014, G0283 (Medicare) |
Documentation Requirements for CPT 97014
To prevent claim denials, documentation must be thorough. Providers should include:
- Certified plan of care detailing treatment goals.
- Objective evidence like range of motion, strength assessments, and pain scales.
- Treatment details include duration, intensity, and frequency.
- Progress reports tracking patient improvements.
- Provider’s signature to validate services rendered.
Medicare & Private Insurance Coverage for 97014
- Medicare: CPT 97014 is not covered by Medicare. Use G0283 instead.
- Private Insurers: Coverage varies.
- OptumHealth and United Healthcare require G0283 for reimbursement.
Comparison of Reimbursement Policies
Insurance Provider | 97014 Coverage | Alternative Code |
Medicare | Not Covered | G0283 |
OptumHealth | Requires G0283 | G0283 |
United Healthcare | Requires G0283 | G0283 |
Common Problems & Solutions When Billing 97014
Here are some common billing issues and how to avoid them:
- Secondary Insurance Denials
- Some secondary insurers don’t cover 97014. Verify coverage before billing.
- Medicare Claim Denials
- Medicare only accepts G0283 for unattended EMS services.
- Audit Triggers
- Incorrect coding or missing documentation may lead to audits. Ensure compliance with payer policies.
- Billing Delays
- Incomplete documentation can cause claim rejections. Always provide detailed treatment records.
Using CPT Code 97032 for Attended Electrical Stimulation
If a provider is actively present during the therapy session, CPT code 97032 should be used instead of 97014. This code is billed in 15-minute units and requires one-on-one patient interaction.
Code | Description | Billing Units |
97014 | Unattended Electrical Stimulation | Once per session |
97032 | Attended Electrical Stimulation | Per 15 minutes |
Final Thoughts
Accurate use of CPT 97014 is essential for proper medical billing and reimbursement. Chiropractors and physical therapists should:
- Use G0283 for Medicare patients to avoid denials.
- Ensure thorough documentation to demonstrate medical necessity.
- Verify payer policies for private insurance coverage.
- Use 97032 for attended electrical stimulation to ensure correct billing.
By following these best practices, providers can streamline their billing process, reduce claim denials, and maximize reimbursement for electrical stimulation therapy.
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