97014 CPT code is used to bill services when electrical stimulation is provided to 1 or more body areas. The 97014 service is provided to the patient’s nerves or muscles that cannot move by themselves or respond on their own.
Physicians pass electrical current through the muscle or nerve that helps them and contract and restore body function of the affected part resulting from a traumatic injury like spinal cord or head injury.
97014 CPT Code Description
97014 CPT code service or session will aid the patient in promoting healing and stimulating muscle function. It will be required direct supervision of the physician, and treatment can be reported only once per day.
If multiple sessions are performed on the same day, it is appropriate to report each treatment session separately.
If one session is performed in different intervals, all intervals are included in CPT 97014. Medicare does not recognize CPT 97014. Therefore, it is appropriate to bill with HCPCS Level II codes G0281-G0283 for Medicare Part-B claims.
Below are the following reasons or benefits of PT (Physical Therapy) when CPT 97014 is performed:
- reduce pain in affected areas by electrical simulation
- Promote efficient blood circulation
- Strengthen muscles and aid in contraction
- Inflamed muscle, tendon, bursa, or ligaments
- Helpful in healing traumatic wounds
There are two types of electrical simulations like Neuromuscular Electrical Stimulation (NMES) and Iontophoresis.
Iontophoresis is treated with medication during PT which pushes through electrical impulses via skin or body, while NMES targets muscles or groups of different muscles to contract by electrical stimulation.
It can cause tissue burn, irritation, and tearing in muscles. However, if electrical stimulation is provided effectively and correctly to the targeted area, it will block the pain triggers point on the muscles.
97014 CPT code is used for billing service when applying a modality to 1 or more areas is performed with electrical stimulation (unattended).
Unattended means that the therapist placed all the parameters electrodes set all the module requirements rest of the things will be done by the patient self with no therapist involvement.
A maximum of 3 CPT 97014 can be billed when Documentation supports this service. Otherwise, CPT 97014 is not a reportable service for Medicare insurance. G0283 codes will be reported instead of CPT 97014.
Modifier 26 or TC are not applicable with CPT 97014. The CPT 97014 cost and RUVS are as follows:
Facility: Cost $14.11, RUVS 0.40771
Non-Facility: Cost $14.11, RUVS 0.40771
97014 CPT Code Modifiers
Below is a list of modifiers that are applicable to append with CPT 97014: 52, 53, 59, XS, XU, XE, XP, 76, 77, 78, 79, 99, AQ, AI, AR, CR, CC, ET, EY, GA, GC, GK, GJ, GR, GY, GU, GZ, KX, PT, QJ, Q5, Q6.
The most frequently billed modifiers are 59, 76, and 77.
If physicians perform two different sessions on the same patient on the same day, it is appropriate to append modifier 76 with 97014 CPT code. In contrast, modifier 77 will be applicable when another Physician performs a different session on the same service date.
A patient is presented to SLP (speech-language pathologist) XYZ for 2 hours session in the morning.
For example, If the same patient comes again to Physician XYZ for another session on the day in the evening, Then Modifier 76 is appropriate with CPT 97014.
In contrast, If the same patient goes to a different Physician ABC for 3 hours session on the same day, the modifier 77 will be applicable with Modifier 77.
Modifier 59 is appropriate to append with CPT 97014 when service is bundled with another procedure on the same day with service that is not usually performed on the same day.
It will be appropriate to check other commercial insurances requirements and vary accordingly for reimbursement purposes.
CPT code 97014 cannot be performed by the patient or without physician assistance, and it requires the supervision of a physician. Documentation is significant to report CPT 97014.
Total sessions of treatments of the same visit on the same date of service will be calculated as one service or unit of CPT 97014.
If CPT 97014 is performed in combination with Acupuncture, CPT codes (97813, 97814) are separately billable, and no modifier is required according to NCCI (National Correct Coding Initiative).
CPT 97014 is allowed to be billed together on the same day with the following CPT codes and append appropriate modifier if required:
Electromyography (95860-95872, 95885, 95886, and 95887), EMG biofeedback training (90901), Nerve Conduction Studies (95905-95913), Muscle and motion range tests (97161-97172).
Each session with a different visit time will be reported separately on the same day.
There are other procedure codes like CPT 64450 (anesthetic injection) that might also be reported with CPT 97014 for pain relief, and no modifier will be required to report this service.
CPT 97014 is appropriate to billable for a condition that treatment is not taken more than 180 calendar days which is considered an acute condition.
The physician will be required to submit an appeal to the insurance if treatment goes beyond 180 days with supportive Documentation that the condition is still acute and has not moved to plateauing.
If a physician has performed CPT 97014 and has more than six sessions or visited the patient for electrical stimulation of pain.
There is no recovery seen within these six visits. Therefore, Documentation should support the services beyond six visits to continue therapy.
ICD 10 codes should reflect the patient’s current condition to meet the medical necessity according to respective LCD/NCDs.
CPT 97014 will not be reported when SLP is not present to trigger the simulation at a specific moment to treat dysphagia.
CPT Code 97014 Examples
The following are numerous examples of when the 97014 CPT code will be billed.
A 35-year-old male was presented to the therapist for a traumatic injury of the shoulder two weeks ago. A patient has 10/10 pain severity, and it was unbearable.
The physician sends the patient to the therapist for electrical stimulation of pain. The therapist attached all the modules electrodes and set all the parameters to the targeted site.
The rest of the simulation was done by the patient under the physician’s supervision without is the involvement. After, he received 30 minutes sessions comprised of two intervals. The patient feels reduced pain and is better than earlier.
Now patient pain severity is 2 out of 10, and feeling much better. Therapist scheduled three more sessions in this week for electrical stimulation of pain.
A 56-year-old male is presented to a therapist for the inflamed muscle of the hip, ankle, and joints. The patient had severe pain in the lower extremity joints. The pain was not healing by any medications and treatments.
The therapist decided to do an electrical stimulation of these joints. He placed all the electrodes to the targeted part and set the module parameters.
The patient rests the area and massages all the lower extremity joints. After a 15 to 20 minutes session, the patient felt better and lower in pain.
Therapies were given in four intervals of 20 minutes. Physician rescheduled electrical stimulation for the next 3 to 4 days of pain management.
A 36-year-old male had surgery on knee joints two weeks ago. He had muscular dystrophy and poor movement. The therapist decided that electrical stimulation improves the blood flow in the knee joint. The patient also had muscle contraction issues and knee pain.
The therapist placed to set the device’s parameters and wires to the targeted kneed joint. The physician was present to supervise the whole session while the patient was doing massage by himself.
There were four sessions done of 15 minutes to massage with medications also. Patients felt good after the session, and the pain was reduced from severe to mild. Therapist scheduled four more sessions to complete heel the pain.
A 59-year-old male is presented to the office for foot drop while walking. He could not pick up his foot during walking and felt unsafe, and had difficulty walking. The physician refers this patient to a therapist for Electrical manipulation for muscle contraction.
The patient was not completely paralyzed, and there were chances of improvement by providing electrical stimulation.
The therapist placed the device in the targeted area and set the device’s parameters. The patient was willing to do the massage by themself. Therefore, the physician only monitors all the sessions provided to the patient.
He received multiple intervals of treatment which consisted of 1 hour. The patient feels improvement in walking, and the foot drop was getting better than earlier.
Physicians rescheduled eight more sessions for next week. The patient also requested therapy for another session in the evening as he was feeling much better.
The therapist provided another session in the evening for a continuation of treatment. The treatment goes well.