CPT code 97140 is frequently used in outpatient rehabilitation and musculoskeletal settings, particularly in care plans that include hands-on treatment. It covers manual therapy techniques that help restore movement, relieve pain, correct soft-tissue restrictions, and support functional recovery. Physical therapists, occupational therapists, and chiropractors often bill this code when they deliver patient-specific manual interventions as part of a structured treatment plan.
In patients with low back pain, for example, manual therapy is used in more than 35% of physical therapy patients, highlighting its clinical importance in outpatient care. Clinicians typically rely on CPT 97140 when tight muscles, stiff joints, or post-injury tissue damage limit a patient’s ability to advance through exercise-based therapy.
Because it is a time-based, direct one-on-one service, accurate reporting and detailed documentation are crucial to support reimbursement. By understanding how CPT 97140 should be applied and justified, providers can reduce billing errors and improve their claim approval rates.
What Is CPT Code 97140?
CPT code 97140 is the billing code used to report manual therapy services delivered through direct, hands-on intervention by a licensed clinician. It represents skilled therapeutic work intended to address specific impairments confirmed during evaluation, not routine wellness or comfort-based care. The code is classified as a time-based, one-to-one service, which means it must be provided in direct contact with the patient and documented according to the applicable timed unit rules.
Clinicians may use 97140 when their treatment plan includes a manual technique that aims to change tissue behavior, joint movement, or physiological response. To qualify for reporting, the service must be part of an established care plan, supported by measurable findings, and tied to a functional treatment goal outlined in the patient record.
When Should CPT 97140 Be Used?
Key Criteria for Use
- The patient has a documented physical impairment that limits progress or functional performance.
- Intervention is clinically justified with measurable findings from evaluation or progress notes.
- Service is part of a planned treatment pathway, not added informally or for comfort alone.
Common Therapeutic Purposes
- Improve joint mobility or range of motion
- Reduce muscle tightness or trigger points
- Break down adhesions or scar tissue
- Address post-injury tissue changes
- Relieve nerve compression symptoms
- Improve circulation in a targeted area
Recommended Practices
- Should directly support short- or long-term goals in the plan of care
- Not intended for maintenance, relaxation, or comfort without measurable outcomes
- Patient must be actively monitored and assessed during the service
Quick Documentation Pointers
- Clearly note why the manual therapy was required
- Specify area treated and relevant findings
- Link treatment to functional outcomes or measurable goals
Manual Therapy Techniques Covered
CPT 97140 covers a range of hands-on therapeutic techniques that a clinician applies directly to a patient to address musculoskeletal or soft-tissue issues. While the code is not tied to one specific procedure.
Common components typically reported under 97140 include:
Myofascial Release
- Gentle sustained pressure and stretching to release fascial restrictions.
- Helps restore tissue flexibility and improve range of motion.
Joint Mobilization
- Targeted movement of joints to improve mobility and reduce stiffness.
- Often used when joint restrictions limit functional activities.
Manual Lymphatic Drainage
- Light, rhythmic techniques to support lymph flow and reduce swelling.
- Common in post-surgical or injury recovery contexts.
Manual Traction
- Application of controlled tension to spinal or peripheral joints.
- Reduces pressure, improves alignment, and can relieve pain.
Soft-Tissue Mobilization
- Includes massage-like techniques targeting muscles, tendons, and ligaments.
- Promotes circulation, eases tension, and facilitates tissue healing.
Note: CPT 97140 does not include passive modalities like heat, ultrasound, or exercise instruction. Only skilled, hands-on techniques with documented therapeutic intent are reportable.
Billing & Reimbursement Requirements
Timed Units
CPT 97140 is a time-based code, with most payers applying the 8-minute rule. Only the hands-on therapy provided directly to the patient counts toward billable units. Accurate timing is essential to ensure correct reimbursement.
One-on-One Requirement
The service must be delivered individually to a single patient. If a clinician treats multiple patients simultaneously, it cannot be billed under 97140.
Pairing With Other Codes
97140 is often billed alongside codes such as 97110 (therapeutic exercise) or 97530 (therapeutic activities). To avoid denials, documentation must clearly differentiate each service and confirm that manual therapy was provided separately from other interventions.
Facility vs. Non-Facility Settings
Reimbursement and coverage may vary depending on the practice setting. Hospitals, outpatient clinics, and private practices can have different fee schedules, so it’s important to verify payer-specific rules.
Tips for Clean Claims
Always link the service to documented functional goals, verify units and timing, and follow payer-specific rules for coverage and visit limits. Proper documentation helps reduce claim rejections and supports faster reimbursement.
Modifier Guidance for CPT 97140
When to Use Modifier 59
Modifier 59 is required when 97140 is billed on the same date as another service that could be considered overlapping, such as 97110 or 97530. It helps clarify that manual therapy was performed as a distinct service. The documentation must show that each intervention addressed different clinical needs or separate body regions.
Using XE, XP, XS, and XU
Some payers prefer the subset modifiers instead of Modifier 59. XE indicates a separate encounter, XP reflects a separate practitioner, XS applies to a separate structure, and XU identifies an unusual, non-overlapping service. These modifiers support accurate coding when manual therapy is delivered under circumstances that require additional clarity.
Common Situations That Require Modifiers
A modifier is typically needed when manual therapy is performed in a different body area than therapeutic exercise, or when services occur at different times within the same visit. Clear justification in the clinical notes helps prevent claims from being bundled or denied.
Modifier Reference for CPT 97140
| Modifier | Meaning | Example Use Case | Key Documentation Requirement |
| 59 | Distinct procedural service | Manual therapy (97140) + therapeutic exercise (97110) on same date | Show separate clinical need or body region |
| XE | Separate encounter | Manual therapy in the morning, exercise later in the day | Document different times of service |
| XP | Separate practitioner | PT performs exercise, OT performs manual therapy | Identify different providers in notes |
| XS | Separate structure | Manual therapy on shoulder, exercise on knee | Specify distinct anatomical sites |
| XU | Unusual, non-overlapping service | Manual therapy technique distinct from other interventions | Explain why service is unique |
Documentation Essentials for CPT 97140
Describe the Techniques Used
Notes should specify the manual therapy techniques applied during the session. Examples include soft-tissue mobilization, joint mobilization, and manual lymphatic drainage. Clear descriptions help distinguish 97140 from other therapeutic procedures.
Record Exact Time Spent
Because 97140 is time-based, the documentation must include the minutes dedicated to manual therapy. Only the hands-on portion counts toward billable units, so accurate timing helps support clean claims.
Identify the Treatment Areas
Listing the exact anatomical regions treated shows medical necessity and supports proper modifier use when multiple services occur in the same visit. This also helps differentiate manual therapy from exercise or activity-based interventions.
Connect Treatment to Functional Goals
Each entry should explain how manual therapy supports the patient’s progress toward functional improvement. Linking the intervention to clinical goals helps demonstrate medical necessity for payers.
Note Patient Response
A brief summary of how the patient responded to the intervention strengthens the record. This may include reduced pain, improved mobility, or tolerance to manual techniques, depending on the clinical outcome.
Common Coding Mistakes to Avoid
- Many denials occur when the documentation does not clearly show the time spent on manual therapy. Since 97140 is a timed code, precise minutes help support accurate unit calculation.
- Claims may be questioned when manual therapy appears to overlap with therapeutic exercise or other services delivered during the same period. Each intervention should reflect its own time and purpose.
- Modifiers are often missed when 97140 is billed with other therapeutic procedures. Using 59 or the X-series modifiers when appropriate helps prevent services from being bundled.
- Some rejections stem from notes that do not specify which body areas were treated. Identifying the anatomical regions involved supports both medical necessity and correct modifier use.
- In certain cases, the technique provided may align better with another CPT code. Selecting 97140 without considering the intent of the intervention can lead to incorrect billing.
For a deeper look at procedure-specific coding, you can also check our guide on commonly used chiropractic CPT codes.
Payer-Specific Considerations
- Medicare / MA Plans
Follow regional LCDs and ensure documentation clearly supports medical necessity. Time, technique, and functional goals must be measurable. - Commercial Payers
Policies vary by plan. Some insurers limit units, require prior authorization, or restrict repeated manual therapy sessions. - Workers’ Compensation & Auto Carriers
Expect stricter documentation and payer-defined fee schedules. Detailed progress notes and functional updates are often required. - Visit Limits & Authorizations
Confirm whether the plan requires preauthorization or has caps for manual therapy services. Verify before scheduling extended care plans. - Audit Awareness
Manual therapy codes are frequently reviewed. Maintain precise timing, technique descriptions, and clear clinical justification to support appeals.
CPT 97140 plays a meaningful role in helping providers reduce pain, improve mobility, and support functional progress through skilled manual therapy. When clinicians apply the code correctly and follow time-based rules, documentation becomes clearer and more consistent. This leads to smoother reimbursement and helps reduce preventable denials.
For chiropractic practices, CPT code 97140 often complements adjustments and supports better overall treatment outcomes. This makes accurate coding and compliant documentation even more important for maintaining a healthy revenue cycle.Working with a billing partner that understands these requirements can lighten the administrative load and improve financial stability. AnnexMed supports chiropractic practices with end-to-end RCM expertise, payer-specific guidance, and reliable claim accuracy. This helps providers stay focused on patient care while we manage the complexities of coding and reimbursement.
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FAQs
CPT 97140 covers manual therapy techniques that chiropractors use to improve joint mobility, relieve soft-tissue restrictions, and support functional recovery. Accurate documentation ensures proper reimbursement.
Insurers typically review treatment notes, time spent, and documented clinical goals. Clear records showing patient-specific interventions and functional progress help justify manual therapy claims.
Yes. 97140 is often billed with codes like 97110 or 97530, but modifiers (59 or X-series) and precise documentation are required to prevent claim denials for overlapping services.
Frequent issues include missing treatment times, unclear body regions, insufficient technique details, or failure to note patient response. Proper one-on-one documentation reduces denials and ensures compliance.
Modifiers like 59, XE, XP, XS, or XU indicate distinct services, encounters, or structures. Correct usage prevents claims from being bundled and ensures proper payment.
