Surgical · General

Skilled, hands-on manual therapy techniques — including joint mobilization/manipulation, manual lymphatic drainage, and manual traction — applied to one or more body regions, billed per 15-minute unit.

Verified May 8, 2026 · 8 sources ↓

Medicare: $27.72
Total RVUs: 0.83
Global, days
Region: General

Drawn from CMSAMAMedsolercmPatientstudioAAPC

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 8 cited references ↓

Specific manual therapy technique used (e.g., joint mobilization, myofascial release, manual traction, manual lymphatic drainage)
Anatomical region(s) treated — named specifically, not just 'affected area'
Timed duration: total minutes of hands-on manual therapy supporting each unit billed
Medical necessity: functional limitations tied to the diagnosis that manual therapy addresses
Measurable treatment goals with objective outcome measures (e.g., ROM degrees, pain scale, functional activity)
Patient response to each session, including changes in pain, range of motion, or function
Connection to the overall plan of care demonstrating why skilled intervention is still required

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

59 Distinct service XS Separate structure

What this code covers

Source · Editorial summary grounded in 8 cited references ↓

97140 covers direct, provider-contact manual therapy requiring clinical skill: joint mobilization or manipulation, manual traction, and manual lymphatic drainage. It's a timed code — each unit represents 15 minutes of actual hands-on work. Billing multiple units requires documented time that supports each unit claimed, and the technique, region treated, and patient response must appear in the note for every session.

Not all hands-on work qualifies here. Massage therapy has its own code (97124), and chiropractic spinal adjustments bill under 98940–98942. Substituting 97140 for those services — or using 97140 and 97124 interchangeably based on what's more likely to pay — is a compliance risk. NCCI edits bundle 97140 with several same-region procedures; when services are genuinely distinct and performed on separate anatomical regions or in separate timed blocks, modifier 59 is the mechanism to unbundle, but only when documentation supports it.

Medical necessity isn't assumed from the diagnosis alone. The note must connect the specific technique to the patient's functional limitations and measurable treatment goals. Auditors look for outcome data, progress toward those goals, and a clear rationale for continuing skilled manual intervention rather than transitioning to home exercise.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.43
Practice expense RVU	0.39
Malpractice RVU	0.01
Total RVU	0.83
Medicare national rate	$27.72
Global period	days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$27.72

Common denial reasons

The recurring reasons claims for CPT 97140 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing or vague time documentation — note doesn't support the number of units billed
Technique not named — 'manual therapy performed' without specifying the method fails audit
Medical necessity not established — no documented functional limitations or measurable goals in the note
NCCI bundling conflict — 97140 billed same-day with a procedure in the same region without modifier 59 and supporting documentation
Upcoding from 97124 — massage therapy documented but billed as manual therapy; payers deny on audit
Modifier 59 applied without documentation of distinct region or separate timed service block

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 8 cited references ↓

01How many units of 97140 can I bill per session?

There's no universal hard cap per session, but each unit requires 15 minutes of direct, skilled manual therapy. Your documentation must show total timed minutes that support every unit billed. Most payers apply a Medically Unlikely Edit (MUE); billing beyond that threshold triggers review regardless of documentation.

02Can 97140 be billed on the same day as 97110 (therapeutic exercise) or 97530 (therapeutic activities)?

Yes, if the services are distinct. NCCI edits exist between 97140 and several other therapy codes. When both are genuinely provided — separate techniques, separate timed blocks, documented independently — append modifier 59 to the column-two code. Do not use 59 as a default; payers and auditors look for documentation that actually supports the distinction.

03What's the difference between billing 97140 and 97124?

97124 is massage therapy — effleurage, petrissage, tapotement. 97140 requires skilled techniques directed at specific joint or soft-tissue dysfunction: mobilization, manipulation, traction, or manual lymphatic drainage. Code based on what was documented and performed. Swapping them for payment reasons is a compliance violation.

04Can an orthopedic surgeon bill 97140?

Yes. CMS PUF data shows orthopedic surgery among the top-billing specialties for this code. Scope-of-practice rules vary by state, but the code itself is not specialty-restricted. Documentation requirements are identical regardless of provider type.

05When is modifier 59 required on 97140?

When 97140 is billed same-day with another procedure that shares an NCCI bundle, and the services were performed on a different anatomical region or in a clearly distinct, separately documented time block. Per CMS MLN guidance, use the most specific X-modifier (XS for separate structure, XE for separate encounter, etc.) when one applies rather than defaulting to 59.

06Does 97140 have a global period?

No. 97140 carries a XXX global period designation, meaning the global period concept does not apply. Each session is billed independently with no bundled pre- or post-service days.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the manual therapy technique by name, the specific region treated, total hands-on time, and the patient's response within the session note. It flags documentation when technique, region, or timed duration are missing — the three elements auditors most commonly cite when denying or downgrading 97140 claims.

See how Mira captures CPT 97140 documentation