CPT 97140: Manual Therapy, and When It Bundles with Other Codes
97140 reports hands-on manual therapy techniques, billed in 15-minute units. Its billing problems come from its neighbors: other therapy codes in the same 15 minutes and chiropractic manipulation in the same spinal region.
Written by Salman Saeed, CEO and Co-Founder · Reviewed by a Certified Medical Coder · Last reviewed October 2026In short: 97140 can be billed with other therapy codes only when each service gets its own block of time, and with chiropractic manipulation only when it is done in a different spinal region and carries modifier 59 or XS. Units follow the 8-minute table and the MUE is 6 a day.
What Does CPT 97140 Report?
97140 is the CPT code for manual therapy delivered to one or more body regions, per 15 minutes. The CMS fee schedule file shortens it to "Manual therapy 1/> regions", and CMS lists it as an "always therapy" code in its 2026 therapy code list.
The region count does not change units. A unit is 15 minutes of the therapist's hands-on time, so working three regions for 15 minutes is 1 unit. The unit table is on the 97110 page and applies unchanged here.
| Item in RVU26D | 97140 |
|---|---|
| Payment status | A (active, paid separately) |
| Work RVU | 0.43 |
| Total RVU, non-facility | 0.83 |
| Professional/technical indicator | 7 (physical therapy service) |
| Global period | XXX |
| Practitioner MUE, effective 10-01-2026 | 6 (indicator 3) |
Can 97140 Be Billed with Other Therapy Codes?
Yes, if each service has its own time. NCCI Chapter XI, section P, item 2, says a provider shall not report more than one physical medicine service for the same fifteen-minute period, with one exception for supervised modalities in the 97010 to 97028 range.
Some NCCI edits pair 97140 with other timed codes. NCCI says those edits may be bypassed with modifier 59 or XU when the two services were done in different timed intervals, even if back to back in one visit. The manual also warns that NCCI does not contain every such pair, so the rule applies without an edit.
The time count still limits the claim. Chapter 5 of the Claims Processing Manual gives a case of 33 minutes of therapeutic exercise and 7 minutes of manual therapy: 40 total minutes is 3 units, billed as 2 units of 97110 and 1 unit of 97140, because the 7 leftover minutes beat the 3 minutes left over from exercise.
97140 is also not separately reportable for canalith repositioning. NCCI Chapter XI says that when 95992 is billed, codes such as 97110, 97112, 97140 and 97530 are not reported for the same service.
Can 97140 Be Billed with Chiropractic Manipulation?
Only in a different region. NCCI Chapter XI, section S, says 97112, 97124 and 97140 are not separately reportable when performed in a spinal region undergoing chiropractic manipulative treatment. If they are done in a different region and the provider is eligible to report physical medicine codes under Medicare, both may be reported with modifier 59 or XS.
The documentation must name the regions treated and the time of each service. See 98940 for the manipulation side.
Medicare also limits who can bill the other half. The Benefit Policy Manual, Chapter 15, section 240, covers a chiropractor only for manual manipulation of the spine, so a chiropractor's 97140 is not a Medicare benefit.
How Does 97140 Appear on the Claim?
On the CMS-1500, Item 24D carries 97140 with GP, plus 59, XU or XS when an edit or a same-day manipulation requires it, and KX above the threshold. Item 24G carries the units. Keep the region and the start and stop time of each service in the note so the modifier is defensible.
Order is free: Chapter 5 says therapy modifiers may be reported in any order, and the form holds four. Payment follows the same-day 50 percent practice expense reduction described on the 97110 page.
What Goes in Item 24G for Manual Therapy?
Manual therapy is billed in 15-minute units. Item 24D carries 97140 with the payer's therapy modifier, Item 24G carries the units, and Item 24E points to the treated condition. A different region or technique billed under another code stays on its own line.
RVU26D gives 97140 status A and multiple-procedure indicator 5. The MUE table allows 6 per date with indicator 3.
Example: A patient with low back pain has 16 minutes of manual therapy and 14 minutes of exercise on 10/21. The claim shows 97140, pointer A (M54.50), 1 unit, $34.00, and 97110, 1 unit. The total timed minutes (30) support two units combined, so the unit split follows the minutes in the note.
Why Is 97140 Denied?
| CARC | What X12 says | What usually causes it |
|---|---|---|
| 97 | The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated | 97140 in the same spinal region as manipulation, or in the same 15 minutes as another code |
| 4 | The procedure code is inconsistent with the modifier used | GP missing, or 59 added with no distinct region or time |
| 151 | Payment adjusted because the payer deems the information submitted does not support this many/frequency of services | Units above the minutes, or above the MUE of 6 |
| 50 | These are non-covered services because this is not deemed a 'medical necessity' by the payer | A chiropractic provider billing 97140 to Medicare |
If these denials keep coming back, our denial management team can work them. Related: CO-97, physical therapy billing and chiropractic billing.
Related Codes
- Physician Fee Schedule relative value files, RVU26D (October 2026) · CMS
- Medicare NCCI Medically Unlikely Edits, practitioner table, effective 10-01-2026 · CMS
- 2026 NCCI Medicare Policy Manual, Chapter XI: Medicine, Evaluation and Management Services · CMS
- Medicare Claims Processing Manual, Chapter 5: Part B Outpatient Rehabilitation and CORF/OPT Services · CMS
- Medicare Claims Processing Manual, Chapter 26: Completing and Processing Form CMS-1500 Data Set · CMS
- Medicare Benefit Policy Manual, Chapter 15: Covered Medical and Other Health Services · CMS
- Annual Therapy Update: CY 2026 therapy code list and dispositions · CMS
- Claim Adjustment Reason Codes · X12
We check every rule, code and deadline against the official source. See our editorial policy.
Common Questions
Straight answers from the team that does the work.
Ask a billing lead directly. A 20-minute call, Monday to Friday, 9am to 5pm Eastern.
01Can 97140 be billed with other therapy codes?
Yes, when each code has its own block of time. NCCI says no two physical medicine services may be reported for the same 15 minutes, and edits can be bypassed with modifier 59 or XU when the intervals differ. The day's total minutes still set the units.
02Can 97140 be billed with 98940?
Only in a different region. NCCI Chapter XI says 97140 is not separately reportable in a spinal region undergoing chiropractic manipulation. In another region, and if the provider can bill physical medicine under Medicare, report both with modifier 59 or XS.
03How many units of 97140 are allowed?
The Medicare practitioner MUE is 6 per date of service as of October 1, 2026. The 8-minute table usually caps it first: 37 total timed minutes is only 2 units, however many units are written on the claim line or planned.
04Does the number of regions change the units of 97140?
No. The CMS file labels 97140 as one or more regions, and a unit is 15 minutes of hands-on time. Three regions in 15 minutes is 1 unit. Region counts matter for bundling with chiropractic manipulation and for the note, not for units.
05Does 97140 need a therapy modifier?
Yes. CMS lists 97140 as an always-therapy code, so it needs GP, GO or GN for the plan of care. When it is billed with another service, 59, XU or XS may also be needed, with the region or time documented.
Manual Therapy Lines Bundling?
We check the region, the time block and the modifier 59 support before the claim goes out.