CPT 97036 Hubbard Tank Reimbursement Benchmarks | OpenPayer

Summary & Overview

CPT 97036: Hubbard Tank Hydrotherapy, Physical Medicine Modality

CPT code 97036 represents the application of a Hubbard Tank modality, a specialized hydrotherapy treatment used in physical medicine and rehabilitation. This procedure is performed in outpatient physical therapy settings and is designed to address a range of musculoskeletal and pain-related conditions, such as low back pain, knee pain, fibromyalgia, and muscle weakness. The code is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare, making it relevant for providers and billing professionals across the United States.

This publication provides a comprehensive overview of 97036, including payer coverage, clinical indications, and related billing codes. Readers will gain insight into the clinical context for Hubbard Tank therapy, typical diagnoses associated with its use, and how it fits within the broader landscape of physical medicine modalities. The analysis also highlights common modifiers and associated taxonomies, offering clarity on documentation and coding practices. Additionally, comparisons to related CPT codes such as 97010, 97110, 97112, and 97113 are included to help distinguish the unique aspects of Hubbard Tank therapy. Policy updates and reimbursement benchmarks are discussed to inform stakeholders about current trends and requirements in medical billing for this service.

AetnaBlue Cross Blue ShieldCigna HealthMedicareUnitedHealthcareCPT 97036Physical MedicineRehabilitation ModalitiesOutpatient Physical TherapyHubbard TankHydrotherapyMedical BillingClinical CodingICD-10Modifiers

CPT Code Overview

CPT code 97036 is used to report the application of a modality to one or more areas using a Hubbard Tank, with each session lasting 15 minutes. This code falls under the category of Physical Medicine and Rehabilitation Modalities, which are designed to assist patients in improving mobility, reducing pain, and enhancing physical function. The typical site of service for this procedure is Outpatient Physical Therapy (Place of Service 11), where patients receive specialized therapeutic interventions in a clinical setting.

Clinical & Coding Specifications

Clinical Context

A patient presents to outpatient physical therapy with chronic low back pain and generalized muscle weakness. The physical therapist evaluates the patient and determines that hydrotherapy in a Hubbard Tank is appropriate to help manage pain and improve mobility. The patient is assisted into the Hubbard Tank, and the modality is applied for 15 minutes. This service is typically performed in an outpatient setting, such as a physical therapy clinic, and is supervised by a licensed physical therapist. The procedure is documented and coded as 97036 for each 15-minute session.

Coding Specifications

Modifier GP: Indicates that the service is part of a physical therapy plan of care. Used when the procedure is performed by a physical therapist or under their supervision.

Modifier Code	Description
`GP`	Physical therapy services modifier

Provider Taxonomies:

National Reimbursement Benchmarks

National mean rates for CPT code 97036 show that Blue Cross Blue Shield, Cigna, UnitedHealth Group, and BUCA (average commercial) all reimburse at higher levels than Medicare. The BUCA mean rate is $37.71, while Medicare's mean rate is $36.13, indicating that commercial payers generally offer slightly higher reimbursement than Medicare for this code.

Rate dispersion varies significantly across payers. Cigna has the widest spread, with a difference of $29.00 between its 75th and 25th percentiles, suggesting greater variability in contracted rates. In contrast, Aetna and Medicare have the tightest ranges, at $10.00 and $4.00 respectively, reflecting more consistent reimbursement levels. The table and chart below present the full breakdown of national benchmarks by payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska exhibits a wide spread in reimbursement rates for CPT code 97036, with the largest rate spread observed in Cigna, where the difference between the 75th and 25th percentiles is $46.39. UnitedHealth Group also shows a narrow spread, with rates tightly clustered between $88.00 and $89.00. Compared to national averages, all commercial payers in Alaska offer substantially higher mean rates, with UnitedHealth Group and Blue Cross Blue Shield standing out for their elevated reimbursement levels.

The table and chart below present the full breakdown of payer-specific rates, including mean, 25th, 50th, and 75th percentiles, highlighting the variation across payers in Alaska.

Key Insights for Alaska

UnitedHealth Group is the highest paying payer in Alaska for CPT 97036, with a mean rate of $84.51.
Medicare is the lowest paying payer, with a mean rate of $34.91.
All commercial payers in Alaska reimburse at rates significantly above their respective national averages, with UnitedHealth Group and Blue Cross Blue Shield showing the largest deviations.

97035 – Application of a modality to 1 or more areas; ultrasound, each 15 minutes

97026-APPLICATION-OF-A-MODALITY-TO-ONE-OR-MORE-AREAS

97026 – Application of a modality to one or more areas; infrared

97012-TRACTION-MECHANICAL-TO-ONE-OR-MORE

CPT 97012: Mechanical Traction Therapy in Physical Medicine

97034-CONTRAST-BATHS-TO-ONE-OR-MORE

CPT 97034: Contrast Bath Therapy, Constant Attendance

97010-APPLICATION-OF-A-MODALITY-TO-ONE-OR-MORE-AREAS-HOT-OR-COLD

CPT 97010: Application of Hot or Cold Packs in Physical Therapy

97018-APPLICATION-OF-A-MODALITY-TO-1-OR-MORE-AREAS-PARAFFIN

CPT 97018: Paraffin Bath Application in Physical Medicine and Rehabilitation

97016-APPLICATION-OF-A-MODALITY-TO-ONE-OR-MORE-AREAS