CPT Code 97014 : Unattended Electrical Muscle Stimulation (EMS) Therapy [Updated 2025 Guide]

CMS 2026 Update — CPT 97014

CMS affirms existing guidance for CPT 97014 (Electrotherapeutic modalities) in the CY2026 MPFS; there are no code deletions or major policy changes for this modality. Providers should continue to document medical necessity, duration, and device used.

What is CPT 97014?

CPT 97014 represents Application of electrical stimulation — a therapeutic procedure used to apply electrical currents to the body to stimulate nerves and muscles, aiding in pain management and muscle rehabilitation.

Typical uses: Pain relief, muscle re-education, and reduction of inflammation.

In short: CPT 97014 = Electrical stimulation therapy.

When to Use CPT 97014 (and When Not To)

Use 97014 for therapeutic electrical stimulation in cases of muscle spasm, pain management, and muscle re-education.

• Report when electrical stimulation is used as part of a physical therapy session.
• Ensure documentation supports the medical necessity of the procedure.

Do not use for procedures involving iontophoresis or when electrical stimulation is not medically necessary.

Clinical Examples

• Chronic back pain management → 97014
• Transcutaneous electrical nerve stimulation (TENS) for home use → G0283

97014 vs G0283 (Quick Comparison)

2025 Reimbursement Rates (Representative)

Documentation Guidelines (CMS & MIPS 2025 Compliant)

Thorough documentation demonstrates medical necessity, skilled care, and functional intent. Include:

1. Functional goal (e.g., “Patient will achieve pain reduction to facilitate daily activities”).
2. Activity description — explicit tasks practiced, environment, and level of assistance.
3. Clinical rationale — why this activity addresses the patient’s deficit.
4. Time documentation — minutes per activity and total minutes (apply the 8-minute rule for units).
5. Patient response — tolerance, cues required, measurable progress.

Sample SOAP Note (De-identified)

S: Patient reports decreased pain in the lumbar region after last session.
O: Electrical stimulation applied to lumbar region for 15 minutes. Patient tolerated well.
A: Continued improvement in pain levels, allowing increased participation in ADLs.
P: Continue with electrical stimulation therapy twice weekly, reassess in 4 weeks.
  

Modifiers & Coding Tips

Claim tip: Ensure documentation supports the use of modifiers to avoid denials.

Common Denials & How to Prevent Them

1. Lack of medical necessity — Fix: Ensure documentation clearly justifies the need for electrical stimulation.
2. Incorrect modifier usage — Fix: Apply appropriate modifiers and ensure documentation supports their use.
3. Missing prior authorization — Fix: Verify payer requirements for prior authorization before treatment.

Audit trigger: Inconsistent documentation of treatment rationale and patient progress.

Region & Local Payer Notes

In Ohio, providers should be aware that local MAC, CGS Medicare, may have specific guidelines for the application of electrical stimulation. It is advisable to consult with CGS Medicare for any region-specific requirements or updates.

FAQs

What is CPT 97014 used for?

CPT 97014 covers electrotherapeutic modalities applied to produce therapeutic changes in soft tissue, muscles, or joints. Document the device, parameters, and clinical rationale in your note. Ensure these modalities are part of an active treatment plan tied to measurable goals.

Do I need prior authorization?

Many commercial payers require prior authorization for repeated modality courses; Medicare usually does not require it for standard use. Always verify the individual plan prior to initiating a course of care to prevent claim denials.

How should I document time and response?

Record start/end times for the modality, parameters used, and patient response to therapy, including any adverse reactions. Document progression or changes in tolerance to support ongoing use.

Can 97014 be billed with therapeutic exercise?

Yes, but you must show that services are distinct and medically necessary; support combined services with documentation.

What are common denial reasons?

Denials often arise from insufficient clinical rationale, missing time documentation, or payer policies limiting modality use.

How to audit-proof modality claims?

Keep structured notes with objective measures, progress toward goals, and clinical reasoning linking the modality to impairment.