2025 CPT code 97813
(Active) Effective Date: N/A Medicine - Acupuncture Feed
Acupuncture with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient.
Modifier 25 can be appended to an E/M code if a significant, separately identifiable E/M service is provided in addition to acupuncture.
Medical necessity for acupuncture often involves demonstrating that the service is being used to treat a diagnosed medical condition, is provided by a qualified professional, and is consistent with generally accepted standards of medical practice. Specific payer guidelines for medical necessity should always be consulted.
In simple words: The acupuncturist inserts thin needles into specific points on your body and applies a gentle electrical current for the first 15 minutes of treatment. This helps to relieve pain and treat various health conditions.
This code represents the insertion of one or more acupuncture needles with electrical stimulation applied for the initial 15 minutes of face-to-face treatment time.It is used for the first 15-minute increment of acupuncture treatment in a given encounter when electrical stimulation is used. Only one initial code (either 97810 or 97813) can be reported per day.
Example 1: A patient presents with chronic low back pain. The acupuncturist inserts needles and applies electrical stimulation to specific points on the patient's back for the initial 15 minutes of treatment., A patient experiencing nausea after chemotherapy receives acupuncture with electrical stimulation. The acupuncturist bills 97813 for the first 15 minutes of treatment. , A patient with chronic neck pain receives their first 15 minutes of acupuncture treatment with electrical stimulation. The acupuncturist bills for 97813.
Documentation should include the following: 1. The diagnosis being treated, 2. The specific acupuncture points used, 3. The type of electrical stimulation applied, and 4. The total face-to-face time spent with the patient.
- Specialties:Acupuncture, Pain Management, Physical Medicine and Rehabilitation
- Place of Service:Office, Independent Clinic, Outpatient Hospital