Summary & Overview
CPT 97026: Infrared Modalities for Therapeutic Management
CPT 97026 represents the application of an infrared therapeutic modality used in physical medicine and rehabilitation to relieve pain and support soft-tissue healing. Nationally, this modality is a common adjunct to physical therapy care plans and is billed when infrared energy is applied to one or more treatment areas. The code is relevant across outpatient office settings where modality-based therapy is delivered.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of reimbursement and coverage considerations, typical clinical contexts where infrared therapy is applied, and operational details relevant to billing and documentation. The content outlines common associated clinical diagnoses and related CPT codes for modality services to help situate CPT 97026 within therapy workflows.
This publication provides benchmarks for how the code is used in practice, identifies policy and coverage themes affecting modality reimbursement, and summarizes clinical scenarios that commonly justify use of the service. Data limitations: Service line metadata is not provided. Data not available in the input where noted.
CPT Code Overview
CPT 97026 denotes the application of an infrared modality to one or more areas. This procedure falls within Physical Medicine and Rehabilitation Modalities and is commonly provided in an office setting (POS 11). The code represents use of infrared energy for therapeutic purposes, typically aimed at pain relief and promoting soft tissue healing.
Clinical & Coding Specifications
Clinical Context
A patient presents to a physical therapy clinic with localized musculoskeletal pain affecting one or more regions (for example, low back pain or unilateral knee pain). The physical therapist performs an evaluation, documents objective findings, and applies an infrared modality (97026) to the affected area(s) as part of a therapeutic session to reduce pain, increase local circulation, and prepare tissues for therapeutic exercise or manual therapy. Treatment is provided in an outpatient office setting (POS 11) by providers under the Physical Therapist taxonomy, with billing tracked using the required Medicare therapy modifier.
Coding Specifications
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Modifiers
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GP: Physical therapy modifier required by Medicare to track therapy services. Use when the service is furnished by a physical therapist or facility providing physical therapy and must be reported for Medicare claims tracking. -
Provider Taxonomies
| Taxonomy Code | Specialty |
|---|---|
225100000X |