In 2025, medical billing continues to evolve with tighter regulations and smarter automation. For healthcare providers and clinics, especially those offering physical therapy, CPT code 97010 is still a commonly asked-about procedure code. But despite its frequent use, this code often leads to confusion, especially around coverage, bundling, and modifiers.
This post breaks down CPT code 97010 from real billing experience, showing how Cures Medical Billing Services can help you get reimbursed correctly and faster.
CPT code 97010 defines the use of hot or cold packs applied to specific areas of the body, usually as part of chiropractic or physical therapy care. It falls under the category of applying therapeutic modalities to one or more areas.
It’s a passive therapy, meaning the patient does not actively participate during the treatment.
Here’s where it gets tricky.
No, Medicare does not reimburse CPT code 97010 when it’s billed alone. This is because CMS considers the hot/cold pack bundled into the overall therapy service.
First-hand insight: Many providers assume it’s a separately billable service, but we’ve seen countless denied claims due to this misunderstanding.
Private insurers may sometimes pay for 97010, but it depends on the payer policy. When in doubt, check with your billing partner—or let Cures Medical Billing Services handle that for you.
Bundled means the service is considered part of a larger treatment session and not eligible for separate reimbursement. For example, when combined with CPT code 97110 (therapeutic exercises), insurers consider the hot/cold pack as prep or cooldown, not a standalone service.
This applies especially to:
In some cases, yes. But modifiers won’t guarantee payment if the service is inherently bundled.
You might use:
Pro tip from our billing team: Don’t rely on modifiers to “unbundle” this code. Instead, document clearly and pair it with appropriate primary codes like 97110 or 97016.
Let’s briefly compare 97010 with other common physical therapy CPT codes:
CPT Code | Description | Bundled by Medicare? |
97010 | Hot/Cold Pack | Yes |
97110 | Therapeutic Exercises | No |
97014 | Electrical Stimulation (unattended) | Yes |
97016 | Vasopneumatic Devices (e.g., compression) | Maybe |
If you’re billing electrical stimulation CPT code 97014, know that it’s also commonly denied unless it’s part of a covered therapy plan.
Yes, but only with clear documentation and understanding that Medicare won’t pay for it. Its greatest use is to help with the medical obligations of other payable services.
Here’s how our team at Cures Medical Billing Services helps:
Dr. M. Thomas, a physical therapist in Florida, shared:
“We used to bill 97010 as a routine, but our reimbursement rate dropped. Cures helped us restructure our documentation and code hierarchy. Now we bundle it smartly, and we’re getting paid better on the actual therapy.”
While CPT code 97010 remains a frequently used code in physical therapy and chiropractic care, understanding its limitations is crucial for financial success in 2025.
CPT code 97010 is normally reflected a bundled service by Medicare and many commercial payers. That means it’s included as part of your primary treatment like therapeutic exercise (97110) and not reimbursed separately. It’s frustrating, but the key is documenting the overall session value and not relying on 97010 for separate payment.
Not necessarily. Even though reimbursement is rare, billing 97010 helps track service usage and may still be paid by some commercial payers. If your practice values accurate reporting or has direct-pay patients, it’s still worth including with proper expectations.
Yes, but it requires clear communication and consent. For Medicare patients, you’ll need to issue an ABN (Advance Beneficiary Notice). For others, ensure your financial policy explains that certain therapies, like 97010, may not be covered, and get their agreement in writing.
Modifiers like GP are necessary for physical therapy claims, but they won’t unbundle 97010. Modifier 59 is only useful in very rare, well-documented situations where 97010 is truly separate and distinct. Our billing experts at Cures have seen that documentation quality not just modifiers—makes or breaks a claim.
Keep it concise but clinically justified. Note why the hot/cold pack was used (e.g., “applied post-therapeutic exercise to reduce inflammation”), for how long, and to which body area. Always tie it to the patient’s plan of care. This helps support the claim—even if reimbursement isn’t guaranteed.
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