Ultrasound therapy has long been a trusted tool in physical rehabilitation. But getting paid for it? That’s a different challenge.
At Cures Medical Billing Services, we’ve seen firsthand how missteps in billing the 97035 CPT code can delay reimbursement and lead to denials.
In this blog, we’ll break down what CPT code 97035 means, how to use it properly, and share our real-world insights to help you get paid faster and more accurately.
The 97035 CPT code is used to explosion healing ultrasound services in physical therapy. This ultrasound treatment uses sound waves to penetrate soft tissues and reduce inflammation.
Improve blood flow, and accelerate healing. It’s commonly billed in outpatient physical therapy clinics and chiropractic offices.
“Ultrasound therapy applied to one or more treatment areas, billed in 15-minute increments.”
That means the provider must spend at least 8 minutes (per the 8-minute rule) delivering ultrasound directly to the patient for one unit to be billable.
CPT code 97035 represents a constant attendance modality, which requires the therapist’s direct, uninterrupted presence during the ultrasound treatment session.
To avoid denials, clearly document:
Incomplete notes are one of the top reasons for 97035 CPT code denials.
One billing unit = 15 minutes of ultrasound. But in reality, you can bill one unit if you spend at least 8 minutes performing the therapy, following CMS’s 8-minute rule.
8-Minute Rule Example:
Total Time | Units Billed |
8–22 min | 1 unit |
23–37 min | 2 units |
38–52 min | 3 units |
If you mix ultrasound with another timed treatment like manual therapy (97140), you must calculate the total time to decide how many units you can bill.
Yes, in many cases, especially if billing through Medicare, you’ll need a modifier to indicate the type of therapy provided:
We recommend appending the GP modifier when billing for ultrasound therapy under CPT 97035, especially for Medicare patients.
Chiropractors may also use 97035 in conjunction with spinal adjustment codes, especially when addressing soft tissue dysfunction. Just ensure there’s proper clinical documentation supporting medical necessity and constant attendance.
Let’s say a patient presents with rotator cuff tendinitis. The therapist applies ultrasound for 12 minutes to the right shoulder.
Billing:
Ensure the documentation covers all the above essentials. That’s how you avoid claim rejections and get paid smoothly.
At Cures Medical Billing, we’ve helped hundreds of practices recover revenue from denied 97035 claims. Most common errors?
Once we trained staff on proper documentation and code combinations, our clients saw reimbursement rates improve by over 30% in 60 days.
The 97035 CPT code offers a reliable way to bill for therapeutic ultrasound, but only if used properly. From the correct modifiers to understanding the 8-minute rule and documenting constant attendance, each step matters.
If your practice struggles with physical therapy billing, trust Cures Medical Billing Services to simplify the process, reduce denials, and speed up reimbursements.
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Yes, most payers require modifiers like GP or GO, depending on the therapy type. Medicare especially requires them.
Yes. It’s a timed CPT code billed in 15-minute increments, following the 8-minute rule for minimum time.
Yes, as long as they document medical necessity, constant attendance, and proper CPT code use per payer policy.
It refers to ultrasound therapy applied to one or more areas for 15 minutes, requiring direct contact between provider and patient.
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