Physical therapy modality CPT codes

The modality codes come in two families, and the family decides how you count. The supervised family, 97010 to 97028, is the patient on the unit while you are free to be elsewhere: packs, mechanical traction, unattended stim, paraffin, whirlpool, diathermy. These are untimed. CMS tells you to enter one unit for an untimed code, however many minutes it ran.

The constant-attendance family, 97032 to 97036, needs you there and working: attended stim, iontophoresis, contrast baths, ultrasound, Hubbard tank. Their minutes go into the day’s timed total and come out in 15-minute units, exactly like therapeutic exercise.

The diagram above is the NCCI rule in one picture. Medicare’s correct-coding manual says no more than one physical medicine service may be reported for the same fifteen minutes, with a single exception: a supervised modality in the 97010–97028 range may share those minutes with other therapy. Ice on the knee during upper-body work is two lines. Ultrasound during exercise is not; it needs minutes of its own.

The PT CPT code lookup tells you what a code covers. This table is the other half: the status letter CMS gives each modality in the 2026 fee schedule file. That letter decides whether a line can be paid at all, before any question of documentation.

B

Bundled: never paid separately; folded into the other services that day

A

Active: paid separately under the fee schedule, if covered

I

Not valid for Medicare: Medicare uses another code for the service

R

Restricted coverage

C

Contractor-priced: the MAC sets the payment, usually case by case on the documentation

Every code above is on CMS’s 2026 “always therapy” list. On a Medicare claim each one carries the therapy modifier for the plan of care it was delivered under, GP for physical therapy, and counts toward the annual threshold that the KX modifier is about.

Hot packs and cold packs share one code, 97010, so the cold pack CPT code and the hot pack CPT code are the same number. Its 2026 Medicare status is B: bundled. CMS’s therapy code list spells out what that means. The code is never paid separately, whether it is billed alone or beside other therapy; billed alone it is denied, with a remittance reason saying payment is included in another service.

It still belongs in the treatment note. CMS wants every intervention identified, timed and untimed, in words that can be matched to the claim. Whether it goes on the claim itself is a payer question: Medicare will not pay it, and commercial contracts set their own rules. Read yours.

Electrical stimulation has three codes, and the right one depends on who is in the room and who is paying.

Two cautions. First, the code follows your attendance, not the machine’s settings. If the patient is alone with the unit, this is the wrong code. Second, the NCCI overlap exception is written for CPT codes 97010–97028. G0283 is a HCPCS code outside that range, so do not assume it can share a quarter-hour with exercise on a Medicare claim without checking your MAC.

97012 is the mechanical traction CPT code: a cervical or lumbar unit doing the pulling while you supervise. It sits in the supervised family and carries Medicare status A, so it is payable, as one unit. Untimed. One unit, however long the table ran.

Traction by hand is a different code. Manual traction is part of manual therapy, so it is billed as 97140 in timed units, with the minutes counted like any other hands-on work. Chiropractic offices bill 97012 beside manipulation; the chiropractic billing codes guide covers that pairing.

97035 is ultrasound, constant attendance, status A. Because it is timed, its minutes join the day’s pool with everything else timed, and that pool, not the list of things you did, sets the units. CMS’s own worked example in the claims manual has 18 min of 97110, 13 min of 97140, 10 min of 97116, 8 min of 97035: 49 timed minutes, which is 3 units. The ultrasound (97035) is the shortest service, so it is the one left off the claim. It stays in the note.

Ultrasound is the code most often performed, documented, and correctly left off the claim.

The 97116 gait training guide draws the same example as minute bars. To run your own day, put the minutes into the units calculator rather than adding units per code.

97039 is for a modality no other code describes. Its Medicare status is C: the fee schedule carries no price, and the MAC sets payment case by case from what you send. So the claim has to say what the modality was and, if you stayed with the patient, for how long. Expect a records request.

The aquatic therapy CPT code, 97113, is not a modality. It sits with the therapeutic procedures beside 97110, not with whirlpool or the Hubbard tank, and it is status A for Medicare. The water is the setting; the service is exercise. Document it as exercise: what was done, the dosage, and why the water was needed, such as unloading a joint that cannot yet tolerate land-based work.

A patient soaking in a whirlpool is 97022, a supervised modality, one unit. A patient doing a supervised exercise programme in a pool with you is 97113.

CMS lists the elements of a treatment note, and modalities trip over two of them: every intervention named in words that match the claim, and both totals recorded. The untimed ones count toward total treatment time even though they never touch the units. The documentation cheat sheet and the worked SOAP note show where each line sits.

When the visit is done, the superbill generator lays the codes and units out for a cash-pay or out-of-network patient.