CPT® Code 97813 is used to report the initial 15 minutes of acupuncture treatment that includes electrical stimulation. This code is used when a licensed practitioner inserts acupuncture needles and applies electrical stimulation while maintaining personal, face-to-face interaction for at least 15 minutes. The stimulation is often low-voltage and intended to intensify the effect of the acupuncture treatment.
Key facts about CPT Code 97813
- Service: Acupuncture with electrical stimulation
- Duration: Initial 15 minutes of direct, one-on-one contact with the patient
- Who performs it: Licensed acupuncturists, MDs, DOs, or other qualified healthcare providers trained in acupuncture
- Common indications: Chronic pain, musculoskeletal disorders, migraines, neuropathy, stress-related conditions
- Modifier usage: Typically not required, but always check payer-specific rules
When to use CPT Code 97813
Use CPT 97813 when the session involves:
- The insertion of needles
- The application of electrical stimulation (e.g., electroacupuncture)
- Direct patient interaction for at least 15 minutes during the treatment
If a session involves multiple time increments, add-on code 97814 should be used for each additional 15-minute unit after the initial one.
This code is distinct from 97810, which refers to acupuncture without electrical stimulation.
Documentation requirements
Proper documentation for CPT 97813 should include:
- Start and stop times or total time spent in direct contact
- Confirmation of electrical stimulation use
- Body regions treated and acupuncture points selected
- Patient’s response to treatment and rationale for continued care
- Any clinical goals (e.g., pain reduction, functional improvement)
Medical necessity must be clearly demonstrated, especially when billing to insurance carriers.
Reimbursement and coding considerations
Many commercial health plans and some Medicare Advantage plans offer coverage for acupuncture with electrical stimulation when certain criteria are met, including:
- Approved diagnoses (e.g., low back pain, osteoarthritis of the knee)
- Licensed provider credentials
- Documentation supporting medical necessity
Tips for successful billing:
- Pair with accurate ICD-10 codes that reflect the clinical condition
- Submit initial 97813 followed by 97814 for extended treatments
- Be aware of visit frequency limits or authorization requirements by payer
How OptiMantra simplifies acupuncture billing and documentation
For acupuncture and integrative medicine practices, OptiMantra offers a robust, specialty-aligned platform that makes it easy to manage time-based codes like 97813. Providers can:
- Use custom templates to document electroacupuncture treatments
- Track treatment duration automatically within the patient chart
- Seamlessly add 97813 and 97814 CPT codes to insurance claims
- Monitor payer rules and ensure compliant billing workflows
- Offer telehealth, scheduling, and intake tools built for holistic practices
Whether you're running a solo acupuncture clinic or a multi-modality wellness center, OptiMantra gives you the tools to streamline operations, reduce claim denials, and grow with confidence.
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