A Guide to Billing Modalities in Physical Therapy

Electrical Stimulation (TENS) Billing

Electrical stimulation is billed using various codes depending on the type. Unattended e-stim (where the therapist sets up the machine and leaves) uses code G0283 for Medicare and 97014 for most commercial payers. Attended e-stim (requiring one-on-one contact) is billed with 97032. Documenting the type of stimulation and whether it was attended or unattended is essential for compliance.

Ultrasound Therapy Coding

Therapeutic ultrasound (CPT 97035) is a time-based code that requires direct, one-on-one provider contact. To bill one unit, you must spend at least 8 minutes performing the service. Your documentation must include the area treated, the duration, and the specific settings used on the ultrasound machine.

Coding for Heat and Cold Therapy

Hot/cold packs (CPT 97010) are considered "supervised modalities," meaning they do not require one-on-one attention. However, this code is often bundled by payers, especially Medicare, into other services performed on the same day. While you should still bill for it, be aware that you may not always receive separate payment.

Modifier 59 for Unbundling: If you perform a modality in a separate and distinct session on the same day as another service (e.g., patient receives morning therapy and returns in the afternoon for a cold pack), you may be able to receive separate payment by appending modifier 59.

Key Strategies

Modalities Billing Checklist

✓ Use the correct code for attended (97032) vs. unattended (G0283/97014) e-stim.
✓ Document time and settings for ultrasound (97035) to support units billed.
✓ Be aware that hot/cold packs (97010) are often bundled by payers.
✓ Use modifier 59 only when services are truly separate and distinct.

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A Guide to Billing Modalities in Physical Therapy

A Guide to Billing Modalities in Physical Therapy

Learn the correct coding and billing practices for common physical therapy modalities, including electrical stimulation (TENS), ultrasound, and heat/cold therapy.

Learn the correct coding and billing practices for common physical therapy modalities, including electrical stimulation (TENS), ultrasound, and heat/cold therapy.

Preston M Voutsi

Article Published

Electrical Stimulation (TENS) Billing

Ultrasound Therapy Coding

Coding for Heat and Cold Therapy

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