CPT Code 97124: Therapeutic Massage

The reimbursement amount for CPT code 97124, which covers therapeutic massage therapy, varies by payer and region. It may also differ in other states or under different insurance plans. Always check with the specific payer or state fee schedule for the most accurate and current rate.

CPT codes 97124 (therapeutic massage) and 97140 (manual therapy) generally cannot be billed for the same patient on the same service date under Medicare and most payers, as they are considered mutually exclusive procedures. Some private payers may allow both codes if the services are provided to distinctly separate anatomical regions. In such cases, modifier 59 or XS may be required to indicate separate and distinct procedures, but reimbursement is not guaranteed, and claims may still be denied.

For CPT code 97124, you can typically bill one unit for every 15 minutes of direct massage therapy provided, following the CMS 8-minute rule46. Medicare and many payers allow up to 4 units (60 minutes) per service date without additional documentation; billing more than four units daily requires clear justification and supporting documentation to be considered for full reimbursement.