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Physical Therapy

CPT 97140 Manual Therapy: Billing Rules, Modifier 59, and NCCI Edits

Manual therapy is hands-on, skilled work — and on the claim, it's one of the codes most likely to hit an NCCI edit. Here's how to bill 97140 cleanly.

By Brandon Seigel, Chief Problem Solver · November 3, 2026 · 6 min read

What CPT 97140 covers

97140 is manual therapy techniques — for example mobilization or manipulation, manual lymphatic drainage, and manual traction — for one or more regions. It is a timed code billed in 15-minute units with direct, one-on-one contact.

What to document

  • The specific technique (for example, grade III posterior glides, soft tissue mobilization).
  • The body region or regions treated.
  • Minutes spent on 97140, separate from other timed codes.
  • The patient's response and how it supports the functional goals.

NCCI edits and modifier 59

Under Medicare's NCCI edits, 97140 is paired with 97530 and with several other codes, including chiropractic manipulation and osteopathic manipulative treatment codes. When a pair is billed on the same day, the second code is denied unless a modifier shows the services were separate and distinct.

Modifier 59 — or the more specific XS, XU, XE, or XP — is appropriate only when the documentation supports it, such as different body regions or separate time periods. Adding 59 by habit is one of the most common audit findings in therapy billing.

Why 97140 gets denied

  • Bundled with 97530 without modifier 59 or an X modifier.
  • Modifier 59 used without documentation of a separate region or time.
  • Technique not described — just "manual therapy" in the note.
  • Units exceeding documented minutes.

Quick answers

Can 97140 and 97530 be billed together?

They are an NCCI pair. They can be billed on the same day only when the services were separate and distinct and the claim carries modifier 59 or an X modifier supported by documentation.

Is soft tissue mobilization billed as 97140?

Yes. Soft tissue mobilization is a manual therapy technique billed under 97140.

How many units of 97140 can I bill?

Units follow documented minutes and the timing rule your payer uses. Some payers also apply their own per-visit limits, so check payer policy.

Sources and further reading

See exactly what's included in our medical billing services for therapy practices, how our percentage-of-collections pricing works, or browse common questions from practice owners.

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