CPT Codes 97810, 97811, 97813, 97814 Primary acupuncture codes: Description, Reimbursement, Billing Guidelines.

Primary Acupuncture Procedures CPT Codes

97810: Manual acupuncture, initial 15 minutes
97811: Manual acupuncture, each additional 15 minutes
97813: Electroacupuncture, initial 15 minutes
97814: Electroacupuncture, each additional 15 minutes

CPT Code 97810 – Description and Overview

CPT code 97810 is used to report acupuncture treatment involving one or more needles without the use of electrical stimulation. It specifically covers the initial 15 minutes of personal one-on-one patient contact during the acupuncture session. This includes the assessment, needle insertion, manual stimulation, and needle removal.

When to Use CPT Code 97810

Acupuncture under this code is used to treat conditions such as:

Chronic pain
Migraines
Postoperative nausea
Stroke rehabilitation
Asthma
Addiction
Other related disorders

The time spent must be face-to-face with the patient, and the code is billed once per session for the first 15 minutes of the session.

Add-On Codes for Additional Time

If the acupuncture session lasts beyond the initial 15 minutes, you should use the add-on code 97811 to report the extra time.
Note: Only one initial treatment per day can be billed under CPT 97810.

Documentation Requirements for CPT 97810

Proper documentation is essential for compliance and accurate reimbursement. Records should include:

Clinical indications for acupuncture treatment
Specific acupoints used during the session
Treatment techniques (manual stimulation, needle retention, etc.)

Exact time spent face-to-face with the patient

Importance of Accurate Use

Correct use of CPT 97810 ensures proper billing, compliance, and reimbursement in acupuncture practices. Accurate documentation supports medical necessity and helps avoid claim denials.

CPT Code 97811 – Description and Overview

CPT code 97811 is used for acupuncture treatment involving one or more needles without electrical stimulation, specifically for each additional 15-minute increment of personal one-on-one contact with the patient beyond the initial 15 minutes reported by CPT 97810.

What CPT Code 97811 Includes

This code covers the reinsertion of needles and manual manipulation to stimulate anatomical points on or in the skin. It applies when the acupuncture session continues beyond the initial treatment period and additional therapeutic time is required to achieve optimal patient outcomes.

When to Use CPT 97811

CPT 97811 should be reported only after the initial service is billed under CPT 97810.
It should not be used independently.

This code is commonly used for treating conditions that require extended acupuncture sessions, such as:

Chronic pain
Stress and anxiety
Migraines
Musculoskeletal disorders
Rehabilitation therapy

Documentation Requirements for CPT 97811

Proper documentation is essential to support billing and ensure compliance. Records should include:

Medical necessity for the extended acupuncture session
Additional time spent beyond the initial 15 minutes
Techniques performed during the extra session
Patient’s response to continued treatment

Billing Guidelines for CPT 97811

Use CPT 97811 only as an add-on code after CPT 97810.
Do not bill 97811 as a standalone service.
Ensure that each 15-minute increment of additional acupuncture time is clearly documented.
Verify payer policies for reimbursement limits and time-based billing rules.

CPT Code 97813 – Description and Overview

CPT code 97813 describes acupuncture treatment with electrical stimulation. It covers the initial 15 minutes of personal one-on-one patient contact, during which acupuncture needles are inserted into specific anatomical points and electrical stimulation is applied via electrodes.
This stimulation enhances the therapeutic effects of traditional acupuncture, improving pain relief and overall treatment outcomes.

Difference Between CPT 97813 and CPT 97810

CPT 97813 and 97810 are both initial acupuncture treatment codes, but they differ based on the use of electrical stimulation:

CPT 97810 – Acupuncture without electrical stimulation.
CPT 97813 – Acupuncture with electrical stimulation.

Only one initial code (97810 or 97813) can be billed per day, depending on whether electrical stimulation is used during the session.

When to Use CPT Code 97813

CPT 97813 should be used for the first 15 minutes of electroacupuncture treatment involving direct, face-to-face time with the patient.
It is appropriate for managing conditions such as:

Chronic pain
Postoperative nausea and vomiting
Stroke rehabilitation
Neuropathy
Musculoskeletal disorders

Other medical conditions responsive to electroacupuncture

Add-On Code for Extended Time (CPT 97814)

If the acupuncture session with electrical stimulation extends beyond the initial 15 minutes, use CPT code 97814 to report each additional 15-minute increment of direct patient contact.

97813 – Initial 15 minutes (with electrical stimulation)
97814 – Each additional 15 minutes (with electrical stimulation)

Documentation Requirements for CPT 97813

Accurate documentation is crucial for compliance and reimbursement. Your clinical notes should include:

Medical necessity for using electrical stimulation
Treatment duration (face-to-face time)
Anatomical points used and electrical parameters applied
Patient’s response and therapeutic benefit observed
Clinical rationale for choosing electroacupuncture over manual techniques

Billing Guidelines for CPT 97813

Bill only one initial service (97813 or 97810) per day.
Use 97814 as an add-on for additional time beyond 15 minutes.
Ensure face-to-face contact and time-based documentation are clearly indicated.
Confirm payer-specific rules for acupuncture reimbursement and coverage limitations.

CPT Code 97814 – Description and Overview

CPT 97814 is appropriate when an acupuncture session with electrical stimulation extends beyond the first 15 minutes.
It applies to continued treatment time that remains medically necessary for optimal patient benefit.

Common conditions treated include:

Chronic pain
Neuropathy
Postoperative discomfort
Stroke rehabilitation
Musculoskeletal disorders
Anxiety or stress-related conditions

Key Billing Rules for CPT 97814

Add-on Code: CPT 97814 cannot be billed alone; it must follow CPT 97813.
Used for Extended Sessions: Represents additional 15-minute increments of treatment.
One Initial Code per Day: Only one of either 97810 (without electrical stimulation) or 97813 (with electrical stimulation) can be billed initially per day.
Additional Time: For each extra 15 minutes of electrical acupuncture treatment, use 97814.

Documentation Requirements for CPT 97814

To ensure compliance and reimbursement accuracy, documentation should include:

Total face-to-face time spent with the patient
Details of electrical stimulation and acupoints used
Medical necessity for extended treatment
Patient’s clinical response to ongoing therapy

Why Proper Use of CPT 97814 Matters

Accurate use of CPT 97814 ensures that acupuncture providers receive appropriate reimbursement for longer treatment sessions involving electrical stimulation.
It also helps maintain payer compliance, prevent claim denials, and reflect the true value of extended therapeutic care.

CPT Code 97815 – Description and Acupuncture Add-On Code Overview

CPT code 97815 is used for acupuncture treatment involving one or more needles, with or without electrical stimulation, for each additional 15 minutes of personal one-on-one contact with the patient beyond the initial acupuncture session.

When to Use CPT Code 97815

This is an add-on code used to represent extended acupuncture treatment time beyond the initial 15 minutes.
It applies when the session continues after the initial acupuncture codes (97810 or 97813).
The time counted for this code excludes needle retention time—only active face-to-face treatment time qualifies.

Documentation Requirements

Proper documentation must include:

Duration of face-to-face time spent with the patient.
Clinical necessity for the extended treatment.
Type of stimulation used (if applicable).

Billing and Reimbursement Notes

CPT 97815 is less commonly used than 97811 and 97814, which are preferred for more precise billing.
Acupuncturists often choose 97811 or 97814 to specify the exact type of stimulation for accurate reimbursement.
Ensure documentation supports the additional treatment time to comply with payer requirements.

Understanding the Differences Between CPT Codes 97811, 97813, 97814, and 97815

CPT Code	Description	Use Case	Time Covered	Electrical Stimulation	Billing Notes
97811	Acupuncture, one or more needles, without electrical stimulation, each additional 15 minutes	Additional time following the initial 97810 manual acupuncture session	Each extra 15 minutes	No	Add-on code, billed after primary 97810
97813	Acupuncture, one or more needles, with electrical stimulation, initial 15 minutes	Initial 15-minute session of acupuncture, including electrical stimulation	First 15 minutes	Yes	Primary code for electroacupuncture, once per day
97814	Acupuncture, one or more needles, with electrical stimulation, each additional 15 minutes	Additional time following initial 97813 electroacupuncture session	Each extra 15 minutes	Yes	Add-on code, billed after primary 97813
97815	Acupuncture, with or without electrical stimulation, each additional 15 minutes after the initial	Additional time added beyond the initial acupuncture session, with or without electrical stimulation	Each extra 15 minutes	Yes/No	Add-on code, less commonly used, sometimes replaced by 97811 or 97814

Summary:

97811 is used for manual acupuncture beyond the first 15 minutes (initial 97810).
97813 is the initial 15-minute acupuncture session with electrical stimulation.
97814 is used for additional 15-minute increments following 97813.
97815 is a less commonly used add-on for extended time, which can cover either with or without electrical stimulation, but 97811 and 97814 are preferred more specifically.

Accurate timing and service documentation are essential for the appropriate use of these codes. For manual acupuncture, use 97810 and 97811; for electroacupuncture, use 97813 and 97814 to reflect initial and extended treatment times, respectively.

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