97140: Manual therapy techniques
Category: Timed therapy
By Dr. Daniel Turner, DC · Reviewed September 2, 2026
What is 97140 used for?
A timed code for hands on manual therapy techniques such as mobilization, manual traction, and myofascial release, billed in 15 minute units of one on one time.
How it works in a chiropractic practice
The most denial prone code in chiropractic billing, because NCCI bundles it with chiropractic manipulative treatment when both target the same region on the same day. Billed with CMT, it pays only when the manual therapy was a distinct service on a separate region, carrying the 59 or XS modifier and documentation proving the separation. Same region soft tissue work preparing for the adjustment is part of the adjustment.
What the note must show
- ✓The specific technique and the region it addressed
- ✓Timed minutes supporting the units, under the 8 minute rule
- ✓When billed with CMT: which regions got manual therapy versus manipulation, showing they differ
- ✓The clinical reason manual therapy was needed as its own service
A worked example
A patient receives a lumbar and sacral adjustment plus 10 minutes of cervical myofascial work for a documented, separate cervical complaint. 98940 plus 97140 with the XS modifier is correct, and the note names the different regions. The same 97140 applied to the lumbar spine right before the lumbar adjustment is bundled into the CMT, and appending 59 to force payment anyway creates recoupment exposure.
What the authorities say
The 97140 and CMT pairing is governed by National Correct Coding Initiative procedure to procedure edits, which treat the two as bundled unless a distinct service on a separate anatomic site is documented and the appropriate modifier is used.
The time rules for 97140
Timed like 97110: the 8 minute threshold for the first unit and the same pooled minutes arithmetic when multiple timed services share the visit.
Billing 97140 with other codes on the same visit
- ✓The most bundled code in chiropractic billing: NCCI pairs it against same day CMT, so it needs the distinct service modifier and a documented separate region
- ✓Against 97124 massage the same day, many payers bundle the pair or pay only one; when both were genuinely performed on different regions, the distinct service modifier and region documentation carry the claim
- ✓Per payer modifier expectations differ: some want 59, some the X subset, some GP as well
Does Medicare pay chiropractors for 97140?
Not payable to chiropractors, as with all non CMT services. For commercial plans it is frequently the single most audited line on chiropractic claims.
Where practices get burned
Reflexive 59 on every 97140; same region billing with CMT; unit counts beyond documented minutes; notes that never say which region the manual therapy touched.
How Cervica helps with 97140
Cervica's claim scrubber validates modifiers, units, and diagnosis pointers for 97140 before submission, per payer rules handle code substitutions and modifier requirements automatically, and when a payer pushes back anyway the denial worklist reads the adjustment codes and routes the claim to the exact fix.
Related codes
- →97110 · Therapeutic exercise
- →97124 · Massage therapy
- →98940 · Chiropractic manipulative treatment, spinal, one to two regions
- →GP modifier · Services delivered under an outpatient physical therapy plan of care
- →CO-97 · the denial this code most often triggers
- →CO-4 · the denial this code most often triggers
- →CO-16 · the denial this code most often triggers
Quick answers
What is 97140 used for?
A timed code for hands on manual therapy techniques such as mobilization, manual traction, and myofascial release, billed in 15 minute units of one on one time.
What documentation does 97140 require?
The specific technique and the region it addressed Timed minutes supporting the units, under the 8 minute rule When billed with CMT: which regions got manual therapy versus manipulation, showing they differ The clinical reason manual therapy was needed as its own service
Does Medicare pay chiropractors for 97140?
Not payable to chiropractors, as with all non CMT services. For commercial plans it is frequently the single most audited line on chiropractic claims.
References
General information for billing teams, not legal, coding, or payer specific advice. CPT is a registered trademark of the American Medical Association; code descriptions here are paraphrased in our own words and the AMA's CPT publications control. Payer policies vary and control for any individual claim.