2025 CPT code 97810
(Active) Effective Date: N/A Medicine Services and Procedures - Acupuncture Procedures Feed
Acupuncture using one or more needles, without electrical stimulation, for the initial 15 minutes of personal, one-on-one contact with the patient.
Modifier 25 can be used with an E/M code if a significant and separately identifiable E/M service is performed in addition to the acupuncture treatment.
Medical necessity must be established for acupuncture services.For Medicare coverage of acupuncture for chronic low back pain, specific criteria must be met, including pain lasting 12 weeks or longer, nonspecific pain with no identifiable systemic cause, and not associated with surgery or pregnancy. For other payers, medical necessity is typically based on the use of acupuncture for the treatment of a specific medical condition.
In simple words: This code covers the first 15 minutes of an acupuncture treatment where the acupuncturist inserts thin needles into specific points on your body. This treatment doesn't involve any electrical stimulation.
This code represents the insertion of one or more acupuncture needles without the use of electrical stimulation during the first 15 minutes of direct contact with the patient.This includes the time spent evaluating the patient, locating acupuncture points, inserting and manipulating the needles, and providing post-treatment instructions. The 15 minutes is based on face-to-face interaction, not needle retention time. This code should not be reported with 97813 (acupuncture with electrical stimulation).
Example 1: A patient presents with chronic low back pain. The acupuncturist performs an evaluation, inserts needles without electrical stimulation at specific points along the back, and provides instructions for home care. The total face-to-face time is 15 minutes. Code 97810 is reported., A patient receives acupuncture for headache relief. The initial treatment without electrical stimulation involves needle insertion at various points on the head and neck and lasts 15 minutes. Code 97810 is reported., A patient undergoes acupuncture for nausea. During the initial 15-minute session, the acupuncturist inserts needles without electrical stimulation at specific points on the wrist and abdomen. Code 97810 is reported.
Documentation should include the total face-to-face time spent with the patient, the specific acupuncture points used, the method of stimulation (if any), and the patient's response to treatment. Any separately identifiable E/M services should also be documented.Medicare requires specific documentation for chronic low back pain diagnosis and treatment response.
- Specialties:Acupuncture, Pain Management, Integrative Medicine, Physical Medicine and Rehabilitation, and other specialties that utilize acupuncture.
- Place of Service:Office, Independent Clinic, Outpatient Hospital, and other places where acupuncture services may be provided.Certain payers may cover in-home services under certain conditions.