Summary & Overview
CPT 98925: Manual Therapy, Controlled Manual Pressure in 1–2 Body Regions
CPT code 98925 denotes a manual therapeutic procedure in which a clinician applies controlled manual pressure to one or two body regions to address somatic and nonsomatic disorders. As a procedure-level CPT code for hands-on therapy, it represents a common noninvasive intervention used across outpatient and ambulatory settings to manage musculoskeletal pain, soft-tissue dysfunction, and related functional complaints. Nationally, accurate coding of such services informs coverage decisions, utilization monitoring, and reimbursement for manual therapy services.
Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service represented by the code, the typical sites where the service is delivered, and which major payers are relevant to coverage and billing discussions. The piece also outlines where to look for benchmarks and policy guidance and highlights common operational issues such as service documentation and appropriate clinical context for reporting the code.
This summary is intended for clinicians, coding professionals, and policy analysts seeking a clear, national-level description of CPT code 98925, its clinical context, and the payer landscape relevant to claims and coverage considerations.
Billing Code Overview
CPT code 98925 describes a manual therapeutic service in which the provider performs controlled manual pressure in one or two body regions to treat somatic and nonsomatic disorders. The service is a hands-on, therapeutic intervention aimed at relieving musculoskeletal or soft-tissue dysfunction and related symptomatology.
Service Type: Manual therapy / manipulative therapeutic service
Typical Site of Service: Outpatient clinic, physician office, or ambulatory care setting
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 42-year-old adult presenting to an outpatient physical medicine clinic with focal myofascial pain and restricted motion of the cervical or lumbar spine after a motor vehicle collision. The patient reports localized neck pain with palpable muscle tightness and tenderness reproducing symptoms. The clinician (physical medicine physician, chiropractor, or licensed massage therapist within scope of practice) performs an evaluation, documents history, focused physical exam including range of motion and palpation, and obtains consent. The procedure consists of controlled manual pressure applied to one or two body regions (for example, right cervical paraspinal region and upper trapezius) to treat somatic dysfunction and reduce muscle hypertonicity. Typical workflow: check-in and vitals, focused evaluation and documentation, targeted manual therapy with monitoring of patient comfort, brief reassessment of range of motion and symptom change, and documentation of time, techniques used, therapeutic response, and any billed modifier(s). Usual site of service is an outpatient clinic, physical therapy or chiropractic office, or ambulatory care center. Billing aligns with one or two body regions addressed during the visit using code 98925.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service on the same day | Use when an independent evaluation and management visit is performed in addition to . |