CPT Code 97039: Unlisted Modality (Physical Therapy)

Learn about CPT Code 97039 with this comprehensive guide for healthcare professionals. Gain clarity on its use and improve your coding practices. Read more!

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What is CPT 97039?

CPT 97039 is one of the procedure codes you’ll use when none of the existing CPT codes quite fit the physical medicine modality you’re delivering. It’s essentially a catch-all code for reporting therapy and rehabilitation services that involve new or uncommon methods like emerging technologies or modified therapeutic devices.

If you're a physical therapist working in an outpatient therapy setting or rehab practice, you might come across situations where this code is the best option. Because it’s an unlisted code, you’ll need to provide detailed documentation to support its use and help ensure accurate reimbursement.

The American Medical Association includes this code to give flexibility when standard codes don’t apply, but it does come with the responsibility of extra justification. Hence, if you're using CPT 97039, make sure your notes clearly explain what you're doing and why it doesn't fall under a more specific code.

CPT 97039 documentation requirements

It’s crucial to back up your claim with clear, complete documentation. Your patient’s medical record should include, at a minimum:

The assessment of the patient by the ordering provider, as it relates to the patient’s complaint during that visit
Relevant medical history
Results of any pertinent tests or procedures
A signed and dated office visit record or operative report (note that all services for Medicare beneficiaries must be signed)
A detailed service description, treatment techniques, including the type of modality used
If the modality requires constant attendance, documentation of the time spent one-on-one by the qualified professional or auxiliary personnel with the patient

Proper documentation is your best tool to support medical necessity and secure reimbursement.

CPT 97039 billing guidelines

When billing CPT 97039, it’s important to understand how it interacts with other codes, especially those involving time-based services. Keep these billing guidelines in mind:

Do not bill CPT 97039 with another constant attendance modality code (CPT 97032–97039) for services delivered during the same time period, even if they’re for different patients.
Avoid billing CPT 97039 together with group therapy (CPT 97150) for overlapping time, as both require distinct patient interaction formats.
Do not report CPT 97039 at the same time as any evaluation or reevaluation code (CPT 97161–97168), whether timed or untimed, as these codes are meant to represent separate clinical components.
Be sure to clearly document the time spent with the patient during the treatment session to support medical necessity and billing accuracy.
If provided on the same day as another service that could raise bundling concerns, consider using a modifier for distinct procedural service (e.g., Modifier -59), when appropriate, with supporting documentation.
Always follow the National Correct Coding Initiative (NCCI) edits designed to prevent improper code combinations and overbilling.

Following these rules helps prevent claim denials and ensures accurate, compliant billing.

Other relevant physical and occupational therapy codes

97139 – Unlisted therapeutic procedure (specify)
97799 – Unlisted physical medicine/rehabilitation service or procedure
97161 – Physical therapy evaluation, low complexity
97165 – Occupational therapy evaluation, low complexity
97140 – Manual therapy techniques, 1 or more regions, each 15 minutes

Frequently asked questions

CPT 97039 is used for unlisted physical medicine modalities, typically involving devices or techniques like ultrasound or electrical stimulation that aren’t represented by other specific codes. In contrast, CPT 97139 is used for unlisted therapeutic procedures, which generally involve active patient participation, such as exercises or movement-based therapies.

CPT 97039 is an unlisted procedure code used to report physical medicine modalities that don’t have a specific CPT code assigned. It requires detailed documentation to describe the service, the type of modality used, and the time spent if constant attendance is involved.

In physical therapy, patient education is a key component of managing chronic pain, helping individuals understand their condition and actively participate in their recovery. It can include guidance on posture, activity modification, self-management techniques, and strategies to reduce pain flare-ups.