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    v1.0.30
    OpenPayerBilling CodesAcupuncture ProceduresCPT cpt-97814-acupuncture-electrical-stimulation-additional-15-min
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    CPT 97814: Acupuncture with Electrical Stimulation, Additional 15 Minutes

    Medicare pays $30 and commercial payers pay $39 on average nationally for this procedure.

    CPT code 97814 describes acupuncture with electrical stimulation provided by piercing the skin with one or more needles and applying electrical stimulation while manipulating the needles; this code represents each additional 15 minutes of direct, one-on-one patient contact after the initial acupuncture service. Service type: acupuncture with electrical stimulation; typical site of service: outpatient clinic or ambulatory care setting where acupuncture is performed.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM), Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®), Lumbar Microdiscectomy.

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    National Reimbursement Benchmarks

    Medicare’s mean rate sits at $29.6, closely aligned with BUCA’s average commercial mean of $39.4 when considering the broader commercial spectrum—BUCA’s mean is about $9.8 higher than Medicare, indicating modest uplift for commercial payers versus the Medicare baseline. The proximity of Medicare’s interquartile values (P25 $28, P75 $30) reflects a narrow Medicare spread around its mean, underscoring relative consistency across localities.

    Examining dispersion (P75 minus P25) highlights which payers have tighter versus wider commercial ranges: Aetna’s IQR is $14.0, Blue Cross Blue Shield’s is $16.1, BUCA’s is $21.3, Cigna’s is $33.4, and UnitedHealth Group’s is $33.0. Medicare’s IQR is $2.0, the tightest of all. Cigna and UnitedHealth Group exhibit the widest dispersion, while Medicare and Aetna show the tightest spreads.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 52-year-old patient with chronic low back pain (M54.5) presents to a physical medicine clinic for acupuncture with electrical stimulation. The patient has failed to achieve adequate pain relief with medication and exercise and has been referred by their primary care physician. The provider performs an initial 15-minute session of acupuncture with electrical stimulation (97813) followed by an additional 15 minutes of stimulated needle contact billed as 97814. The clinical workflow includes pre-procedure evaluation (pain history, review of medications and anticoagulation status, informed consent), preparation of a clean treatment area, sterile single-use needles placed at targeted lumbar and paraspinal points, attachment of a transcutaneous electrical stimulation device to selected needles, monitoring of patient comfort during the additional 15-minute interval, removal and proper disposal of needles, brief post-procedure assessment for immediate adverse events, and documentation of time spent in one-on-one patient contact. Typical sites of service are outpatient clinic treatment rooms in an acupuncture practice, physical medicine and rehabilitation clinic, or integrated primary care setting. The patient encounter is coded with the initial acupuncture with electrical stimulation code and 97814 for the additional 15-minute increment of electrical-stimulation acupuncture contact when applicable.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    171100000X
    208D00000X
    208100000X
    363LN0000X
    2355S0801X
    2080P0201X
    207ZP0007X
    2081P0004X

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    B02.9Zoster without complications
    G43.909Migraine, unspecified, not intractable, without status migrainosus
    G44.1Vascular headache, not elsewhere classified
    G89.29Other chronic pain
    M25.40Effusion, unspecified joint
    M25.50Pain in unspecified joint
    M25.561Pain in right knee
    M25.562Pain in left knee
    M47.816Spondylosis without myelopathy or radiculopathy, lumbar region
    M51.26Other intervertebral disc displacement, lumbar region

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Lumbar Microdiscectomyuniverahealthcare2026-10-15
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Decompressionuniverahealthcare2026-10-15
    Responsive Neurostimulation for Focal EpilepsyPremera Bluecross2026-10-14
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    High-Intensity Focused UltrasoundMass General Brigham Health Plan2026-10-01
    Vagal Nerve StimulationAmbetter Nevada2026-10-01

    Related Codes

    CPT-97810-ACUPUNCTURE-INITIAL-15-MINUTE-TREATMENT

    CPT 97810: Acupuncture, Initial 15-Minute Needling

    CPT-97811-ACUPUNCTURE-ADDITIONAL-15-MINUTE-CONTINUATION

    CPT 97811: Acupuncture, Each Additional 15 Minutes

    CPT-97813-ELECTROACUPUNCTURE-INITIAL-15-MINUTE-TREATMENT

    CPT 97813: Electroacupuncture, 15-Minute Initial Treatment

    CPT-98002-NEW-PATIENT-TELEHEALTH-EVALUATION-MODERATE-COMPLEXITY

    CPT 98002: New Patient Telehealth E/M, Moderate Complexity

    CPT-98003-TELEMEDICINE-NEW-PATIENT-EVALUATION-HIGH-COMPLEXITY-60MIN

    CPT 98003: New Patient Telehealth E/M, High Complexity, 60+ Minutes

    CPT-98005-ESTABLISHED-PATIENT-TELEHEALTH-EVALUATION-20-MINUTES

    CPT 98005: Established Patient Telehealth E/M, Low MDM, ≥20 Minutes

    CPT-98008-NEW-PATIENT-AUDIO-ONLY-EVALUATION-AND-MANAGEMENT

    CPT 98008: New Patient Audio-Only Evaluation and Management

    CPT-98016-VIRTUAL-BRIEF-EVALUATION-ESTABLISHED-PATIENT

    CPT 98016: Virtual Check‑in for Established Patient, 5–10 Minutes

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    97810Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one‑on‑one contact with the patientAlternative initial code for acupuncture sessions that do not use electrical stimulation; used when electrical stimulation is not applied.
    97811Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one‑on‑one contact with the patientUsed to report additional 15-minute increments for acupuncture without electrical stimulation when sessions exceed the initial 15 minutes.
    97813Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one‑on‑one contact with the patientThe primary initial service code when electrical stimulation is used; 97814 is billed for each subsequent 15-minute increment.
    97814Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one‑on‑one contact with the patientRepresents subsequent 15-minute increments of acupuncture with electrical stimulation following the initial 97813 service.