Massage Therapeutic Procedures - CPT Code 97124

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.

What is CPT Code 97124?

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:

• Category: Physical and Rehabilitation Therapy
• Code Type: Time-based (15-minute increments)
• Add-on Code: Not applicable

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.

Who Can Perform CPT 97124 Services?

The following professionals are eligible to perform and bill for services under CPT 97124:

• Physical Therapists
• Occupational Therapists
• Chiropractors
• Physical Therapy Assistants (PTA)
• Occupational Therapy Assistants (OTA)
• Massage Therapists
• Physicians

Important: CPT 97124 does not cover myofascial release techniques, which should instead be billed under CPT 97140.

Types of Massage Therapy Techniques Included in CPT 97124

Massage therapy billed under CPT 97124 includes Swedish massage techniques aimed at improving muscle relaxation, circulation, and function. Here are the core techniques:

1. Effleurage (Stroking)

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:

• Enhances muscle relaxation
• Reduces stress in stiff joints
• Improves lymphatic drainage post-surgery or injury

1. Tapotement (Percussion)

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:

• Stimulates skin and muscle reflexes
• Improves circulation by flushing toxins

1. Petrissage (Compression)

This kneading technique applies deep pressure to release muscle tension, reduce soreness, and improve circulation.

Benefits:

• Stimulates skin and muscle reflexes
• Improves circulation by flushing toxins

1. Petrissage (Compression)

This kneading technique applies deep pressure to release muscle tension, reduce soreness, and improve circulation.

Benefits:

• Loosens tight muscle fibers
• Reduces delayed-onset muscle soreness (DOMS)
• Breaks down adhesions from injury or surgery

1. Deep Friction Massage

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.

Coding Guidelines for CPT 97124

Proper coding is essential for accurate reimbursement and compliance. Here are the main guidelines:

Timed Procedure Code

• CPT 97124 is billed in 15-minute increments.
• CMS 8-Minute Rule: At least 8 minutes of direct contact must be provided to bill a single unit.

Unit Calculation

Units Minutes

1 8-22

2 23-37

3 38-52

4 53-67

Physical Therapy Modifiers

Certain modifiers are required to specify the type of service provider:

• GP: Physical Therapy
• GO: Occupational Therapy
• GN: Speech-Language Pathology
• CQ: Services by a PTA
• CO: Services by an OTA

Documentation Requirements

To ensure successful reimbursement, the following must be documented:

• Medical Necessity: Evidence that the therapy addresses a specific condition (e.g., muscle contracture, decreased ROM, soft tissue adhesions).
• Direct Contact Time: Start and end times for each session.
• Therapeutic Goals: How massage therapy contributes to the patient’s overall treatment plan.

Common Restrictions for CPT 97124

• Myofascial release (CPT 97140) cannot be billed under CPT 97124.
• Services like massage chairs and water massage beds are not covered.
• Percussion techniques for postural drainage must be billed under alternative codes.

Medical Necessity and Reimbursement Guidelines

• Massage therapy under CPT 97124 is considered medically necessary if it addresses conditions such as:

Conclusion

CPT code 97124 is invaluable 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.