CPT code 97124 is specifically designed for billing therapeutic massage procedures conducted by qualified healthcare professionals. Understanding the nuances of this code is essential for proper reimbursement and compliance with medical billing standards. This guide will break down everything you need about CPT 97124, including its definition, applications, and documentation requirements.
CPT 97124 refers to a time-based therapeutic procedure for massage therapy. Each session includes 15-minute increments and encompasses techniques such as effleurage, petrissage, Tapotement, and deep friction massage.
Key Details:
This code is primarily used when a qualified healthcare professional administers massage therapy to address specific medical conditions in a clinical setting. For example, CPT code 97124 may improve muscle function and circulation through targeted therapeutic techniques.
The following professionals are eligible to perform and bill for services under CPT 97124:
Important: CPT 97124 does not cover myofascial release techniques, which should instead be billed under CPT 97140.
Massage therapy billed under CPT 97124 includes Swedish massage techniques aimed at improving muscle relaxation, circulation, and function. Here are the core techniques:
Effleurage involves smooth, flowing strokes that promote relaxation and increase blood and lymphatic circulation. This technique is typically used at the beginning or end of a massage session.
Benefits:
Tapotement delivers rhythmic, percussive taps using cupped hands, fingertips, or the edge of the hand. It targets larger muscle groups like the gluteus maximus while avoiding bony areas.
Benefits:
This kneading technique applies deep pressure to release muscle tension, reduce soreness, and improve circulation.
Benefits:
Deep friction massage applies firm pressure to underlying tissues, mobilizing adhesions and improving range of motion (ROM).
Goal: Prevent or release scar tissue to restore functional movement.
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Proper coding is essential for accurate reimbursement and compliance. Here are the main guidelines:
Timed Procedure Code
Units | Minutes |
1 | 8-22 |
2 | 23-37 |
3 | 38-52 |
4 | 53-67 |
Certain modifiers are required to specify the type of service provider:
To ensure successful reimbursement, the following must be documented:
Massage therapy under CPT 97124 is considered medically necessary if it addresses conditions such as:
To qualify for reimbursement:
Tip: For myofascial release or manual lymphedema drainage, use the appropriate 97140 CPT code to avoid claim denials. Aligning your documentation with the 97124 CPT code description ensures accuracy.
CPT code 97124 offers an invaluable tool for billing therapeutic massage techniques, but it requires meticulous documentation and adherence to coding guidelines. If you’re navigating the complexities of massage therapy billing, partnering with a professional billing company like Cures Medical Billing can ensure accurate claims, reduce denials, and maximize reimbursements. Contact us today to simplify your medical billing process.
CPT 97124 is the billing code used for massage therapy performed by licensed professionals. It includes techniques like effleurage (stroking), Petrissage (kneading), and Tapotement (percussion), which are used to improve circulation, reduce pain, and promote relaxation or healing.
Licensed massage therapists, physical therapists, chiropractors, and sometimes occupational therapists can bill for CPT 97124 as long as the service is medically necessary and part of a treatment plan.
It depends on the patient’s insurance. Some health plans cover medically necessary massage therapy with proper documentation, while others may consider it elective. Always check with the payer first.
CPT 97124 is a time-based code, billed in 15-minute units. So if a session lasts 30 minutes, providers can bill two units of 97124.
Providers should clearly document:
This supports medical necessity, which is crucial for reimbursement.
No, they’re different.
Yes, but only if:
Make sure your notes clearly explain the distinction.
Medicare’s national average is about $20–$25 per 15-minute unit, but it varies by location and payer. Private insurance may reimburse more or less.
Top reasons include:
A clean claim starts with accurate coding and clears clinical notes.
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