Manual Therapy CPT Code 97140: Complete Billing & Documentation Guide

CMS 2026 Update — CPT 97140

CPT 97140 (Manual therapy) policy remains consistent for CY2026; CMS continues to require documentation showing skilled hands-on techniques, clinical reasoning, and functional outcomes.

What is CPT 97140?

CPT 97140 represents manual therapy techniques — a set of hands-on techniques used to treat musculoskeletal pain and dysfunction. These techniques include mobilization, manipulation, manual lymphatic drainage, and manual traction.

Typical uses: This code is commonly used in physical therapy, chiropractic, and osteopathic practices to address joint stiffness, muscle tension, and pain.

In short: CPT 97140 = Manual therapy for musculoskeletal issues.

When to Use CPT 97140 (and When Not To)

Use 97140 for manual therapy techniques applied to one or more regions of the body.

• Report when manual therapy is performed to improve joint mobility or reduce pain.
• Ensure documentation supports the medical necessity of the therapy.

Do not use for general massage therapy or when manual therapy is not medically necessary.

Clinical Examples

• Patient with chronic neck pain receives cervical spine mobilization → 97140
• Patient receives general massage for relaxation → Not 97140

97140 vs 97110 (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 increased range of motion in the shoulder”).
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 shoulder pain after last session.
O: Performed joint mobilization on right shoulder for 15 minutes.
A: Improved shoulder mobility noted; patient tolerated well.
P: Continue manual therapy twice weekly to further improve range of motion.
  

Modifiers & Coding Tips

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

Common Denials & How to Prevent Them

1. Lack of medical necessity — Fix: Provide detailed documentation of the patient's condition and the necessity of manual therapy.
2. Incorrect modifier usage — Fix: Use modifiers appropriately and ensure documentation supports their use.
3. Insufficient documentation — Fix: Include comprehensive notes that cover all aspects of the therapy session.

Audit trigger: Repeated billing of manual therapy without clear documentation of necessity and outcomes.

Region & Local Payer Notes

In Pennsylvania, CPT 97140 is subject to local MAC guidelines provided by CGS Administrators. Ensure compliance with regional policies and verify specific payer requirements to avoid claim denials.

FAQs

What documentation supports 97140?

Document the specific manual techniques used, clinical rationale for selection, duration, and patient response.

Is 97140 considered skilled care?

Yes, when manual therapy requires professional skill, decision-making, and hands-on adjustments for therapeutic benefit.

How long should a session be documented?

Record the minutes spent performing manual techniques and overall treatment time to meet timed code rules.

Can manual therapy be performed by assistants?

Billing rules vary by payer and discipline; many payers require licensed professionals to perform skilled manual therapy.

What are common denials?

Denials stem from insufficient detail about techniques, missing clinical rationale, or lack of measurable outcomes.

How to combine manual therapy with other services?

When combining with therapeutic exercise, document how each service is distinct and medically necessary.