Current Procedural Terminology (CPT) codes are the standardized five-digit language used by healthcare providers and insurance companies to describe medical procedures and services. These codes ensure that services rendered, such as those provided during physical therapy, are accurately documented for payment. The therapeutic application of hot or cold packs is represented by CPT code 97010, not 97014, which refers to unattended electrical stimulation. This service involves using thermal agents to address pain, inflammation, and muscle stiffness as part of a rehabilitation plan.
Understanding Code 97010
CPT code 97010 covers the application of a modality to one or more areas using hot or cold packs. This single code encompasses both thermotherapy (heat, often delivered via a hydrocollator pack) and cryotherapy (cold, using ice or commercial packs).
This code is classified as a “supervised modality.” This means the application does not require the physical therapist or professional to be in constant, one-on-one contact with the patient. The practitioner prepares the patient, ensures safety, and may attend to other patients while the treatment is in progress.
The application of hot or cold packs is considered an untimed service. Untimed services are billed once per patient encounter, regardless of the duration or the number of body areas treated. The provider bills a single unit of CPT 97010, contrasting with timed codes where billable units depend on direct time spent with the patient.
How the Treatment is Applied
The decision to use heat or cold depends on the patient’s condition and stage of injury. Heat application (thermotherapy) works by causing vasodilation, the widening of blood vessels. This increases blood flow, delivering oxygen and nutrients while flushing out metabolic waste products that contribute to soreness.
Increased circulation helps to reduce muscle spasms and relieve chronic pain by relaxing soft tissues, often preparing the area for more active therapeutic exercises. Conversely, cryotherapy utilizes cold to cause immediate vasoconstriction, which constricts the blood vessels. This process is beneficial in the acute phase of an injury or immediately following surgery to manage swelling and inflammation.
By slowing blood flow, cold application reduces the accumulation of fluid in the tissues and provides a temporary analgesic effect by decreasing nerve-conduction velocity. The treatment is typically administered for 15 to 20 minutes, as continuous application beyond this time may reverse the intended physiological effects. Thermal application is frequently integrated as a preparatory or concluding step in a physical therapy session.
Billing Requirements for This Service
For CPT code 97010 to be billed, the treatment must be documented as medically necessary and consistent with the patient’s diagnosis and plan of care. A qualified professional must establish the rationale for using the thermal agent. The documentation must specify the type of pack used, the body area treated, and the intended therapeutic goal.
Since CPT 97010 is an untimed, supervised modality, it is often billed in combination with hands-on, timed procedures, such as therapeutic exercise or manual therapy. However, many commercial and government payers, including Medicare, often do not separately reimburse for this code. Medicare designates it as a Status B code, meaning payment is considered “bundled” into the reimbursement for other, more complex services provided during the same visit.
The code is billed only once per day, regardless of how many times or areas the packs were applied during that session. Even when not separately reimbursed, the service must be included on the claim to accurately represent all care provided. Patients reviewing their Explanation of Benefits (EOB) may see this charge listed, but its inclusion does not always translate to an out-of-pocket cost if the payer considers the service bundled.