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HCPCS K1004: Low Frequency Ultrasonic Diathermy Device for Home Use

HCPCS Level II code K1004 covers a low frequency ultrasonic diathermy treatment device intended for home use. This code identifies durable therapeutic equipment used by patients outside clinical settings to deliver low-frequency ultrasonic diathermy for ongoing symptom management and rehabilitation. The code is significant nationally as it defines billing and coverage pathways for home-based therapeutic devices that can affect access to non-pharmacologic pain and tissue-healing treatments.

Key payers considered in the national analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns, common modifier usage, and clinical context for device deployment in home settings. The publication summarizes reimbursement benchmarks where available, typical documentation and billing considerations tied to home durable medical equipment, and policy trends that influence payer coverage of therapeutic home devices.

This resource is designed for clinicians, billing professionals, and policy analysts seeking a concise reference on coding, payer coverage considerations, and the clinical role of home-use low frequency ultrasonic diathermy devices.

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Billing Code Overview

HCPCS Level II code K1004 describes a low frequency ultrasonic diathermy treatment device for home use. The service type is durable medical equipment (therapeutic home medical device) intended to deliver low-frequency ultrasonic diathermy therapies outside of clinical settings. The typical site of service is the patient's home, where the device is used for ongoing therapeutic treatment under the direction of a clinician.

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HCPCS K1004: Low Frequency Ultrasonic Diathermy Device for Home Use

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Billing Code Overview

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Clinical & Coding Specifications

Clinical Context

A 64-year-old patient with chronic lateral epicondylitis and persistent forearm pain is discharged with a prescription for a low frequency ultrasonic diathermy treatment device for home use (K1004). The device is provided after an in-clinic evaluation by a physical medicine and rehabilitation physician who documents failure of conservative in-office therapies (home exercise program, manual therapy, and supervised physical therapy) and ongoing functional limitation. The clinical workflow: initial office visit with history, physical exam, and diagnosis; trial of in-office modalities; order and documentation for a durable medical equipment (DME) home-use ultrasonic diathermy device; completion of DME order form and supplier documentation; patient education on device use, safety precautions, and prescribed treatment parameters; delivery and setup by a DME supplier with return-to-provider follow-up to assess response and adjust the care plan. Typical duration of home use is specified in the order (for example, daily treatments for 4–6 weeks) with periodic clinical reassessment.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documentation supports substantially greater work or resources for evaluation and device fitting beyond typical time.
`52`	Reduced services	Use when the device is provided but services are partially reduced or not completed as ordered.
`53`	Discontinued procedure	Use when device setup or training is begun but discontinued for documented patient safety or clinical reasons.
`54`	Surgical care only	Rarely used; apply when surgical responsibility is transferred but DME-related postoperative modalities are billed separately.
`55`	Postoperative management only	Use if the physician bills for follow-up management related to device prescription separate from initial encounter.
`56`	Preoperative management only	Use if preoperative evaluation resulting in DME prescription is billed apart from subsequent care.
`62`	Two surgeons	Use when two surgeons with different specialties share responsibility for a case that results in a postoperative DME prescription.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use only when applicable personnel assist in a related procedure that precipitates DME need.
`NU`	New equipment	Use to indicate the device is newly furnished to the beneficiary, not refurbished.
`QX`	CRNA service: medical direction by physician	Use when anesthesia services are relevant in an associated procedure that led to the device prescription.
`QY`	Medical direction of one CRNA by anesthesiologist	Similar use as `QX` when applicable to a related surgical episode.

Taxonomy Code	Specialty	Notes
`207R00000X`	Physical Medicine & Rehabilitation	Commonly evaluates musculoskeletal pain and prescribes home therapeutic modalities.
`207L00000X`	Pain Medicine	Prescribes modalities for chronic pain management and oversees device-based therapies.
`208800000X`	Physical Therapist	Performs in-clinic trials, trains patients on device use, and documents functional outcomes.
`207K00000X`	Orthopedic Surgery	May prescribe postoperative or nonoperative DME for musculoskeletal conditions.
`364S00000X`	Durable Medical Equipment & Supplies Suppliers	Not a clinician taxonomy but the supplier taxonomy commonly used for DME furnishing and billing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M77.1`	Lateral epicondylitis	Common indication for therapeutic ultrasound/diathermy to reduce tendon pain and promote tissue healing.
`M54.5`	Low back pain	Ultrasonic diathermy may be prescribed for chronic localized low back pain as part of home therapy.
`M25.5`	Pain in joint	General joint pain diagnoses where adjunctive home modalities are used to manage symptoms.
`M79.1`	Myalgia	Diffuse muscle pain that may benefit from home-based therapeutic diathermy for symptom relief.
`M75.1`	Rotator cuff syndrome	Shoulder tendinopathies often receive home modality prescriptions when conservative measures are indicated.
`G89.29`	Other chronic pain	Chronic pain conditions managed with multimodal therapy, including home-use diathermy for symptom control.
`M70.6`	Prepatellar bursitis	Localized bursitis where therapeutic diathermy can be part of nonoperative management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97110`	Therapeutic exercises to develop strength and endurance, range of motion and flexibility	Often provided during clinic PT sessions before or alongside home diathermy prescription to document conservative care.
`97010`	Application of a modality to 1 or more areas; hot or cold packs	Frequently used in-clinic as an initial modality trial before prescribing a home ultrasonic diathermy device.
`97140`	Manual therapy techniques (e.g., mobilization/manipulation)	Used in evaluation and conservative care prior to issuing the home-use diathermy device.
`99070`	Supplies and materials (for DME-related patient education or single-use items)	Billed when additional supplies or educational materials accompany device delivery.
`99024`	Postoperative follow-up visit included in global service	Relevant when device prescription is part of postoperative management and follow-up visits are billed per payer rules.

HCPCS K1005: Disposable Breast Milk Collection and Storage Bag

HCPCS-K1006-HOME-SUCTION-PUMP-URINE-MANAGEMENT

HCPCS K1006: Home Suction Pump for External Urine Management

HCPCS-K1007-POWERED-BILATERAL-LOWER-EXTREMITY-ORTHOSIS

HCPCS Level II K1007: Powered Bilateral Lower‑Extremity Orthosis

HCPCS-K1009-SPEECH-VOLUME-MODULATION-SYSTEM

HCPCS K1009: Speech Volume Modulation System, All Components and Accessories

HCPCS-K1010-INDWELLING-INTRAURETHRAL-DRAINAGE-DEVICE-REPLACEMENT

HCPCS K1010: Indwelling Intraurethral Drainage Device, Replacement Only

HCPCS-K1011-ACTIVATION-DEVICE-INTRAURETHRAL-DRAINAGE-VALVE-REPLACEMENT

HCPCS Level II K1011: Activation Device for Intraurethral Drainage Valve

HCPCS-K1012-CHARGER-BASE-INTRAURETHRAL-ACTIVATION-DEVICE-REPLACEMENT

HCPCS K1012: Charger and Base for Intraurethral Activation Device, Replacement Only

HCPCS-K1013-ENEMA-TUBE-REPLACEMENT

HCPCS Level II K1013: Enema Tube, Replacement Only

HCPCS-K1014-ENDOSKELETAL-KNEE-SHIN-4-BAR-FLUID-CONTROL

HCPCS K1014: Endoskeletal Knee-Shin System with Fluid Swing/Stance Control

HCPCS-K1015-FOOT-ADDUCTUS-POSITIONING-DEVICE-ADJUSTABLE

HCPCS K1015: Foot Adductus Positioning Device, Adjustable

Showing 1–10 of 32

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documentation supports substantially greater work or resources for evaluation and device fitting beyond typical time.
`52`	Reduced services	Use when the device is provided but services are partially reduced or not completed as ordered.
`53`	Discontinued procedure	Use when device setup or training is begun but discontinued for documented patient safety or clinical reasons.
`54`	Surgical care only	Rarely used; apply when surgical responsibility is transferred but DME-related postoperative modalities are billed separately.
`55`	Postoperative management only	Use if the physician bills for follow-up management related to device prescription separate from initial encounter.
`56`	Preoperative management only	Use if preoperative evaluation resulting in DME prescription is billed apart from subsequent care.
`62`	Two surgeons	Use when two surgeons with different specialties share responsibility for a case that results in a postoperative DME prescription.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use only when applicable personnel assist in a related procedure that precipitates DME need.
`NU`	New equipment	Use to indicate the device is newly furnished to the beneficiary, not refurbished.
`QX`	CRNA service: medical direction by physician	Use when anesthesia services are relevant in an associated procedure that led to the device prescription.
`QY`	Medical direction of one CRNA by anesthesiologist	Similar use as `QX` when applicable to a related surgical episode.

Taxonomy Code	Specialty	Notes
`207R00000X`	Physical Medicine & Rehabilitation	Commonly evaluates musculoskeletal pain and prescribes home therapeutic modalities.
`207L00000X`	Pain Medicine	Prescribes modalities for chronic pain management and oversees device-based therapies.
`208800000X`	Physical Therapist	Performs in-clinic trials, trains patients on device use, and documents functional outcomes.
`207K00000X`	Orthopedic Surgery	May prescribe postoperative or nonoperative DME for musculoskeletal conditions.
`364S00000X`	Durable Medical Equipment & Supplies Suppliers	Not a clinician taxonomy but the supplier taxonomy commonly used for DME furnishing and billing.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M77.1`	Lateral epicondylitis	Common indication for therapeutic ultrasound/diathermy to reduce tendon pain and promote tissue healing.
`M54.5`	Low back pain	Ultrasonic diathermy may be prescribed for chronic localized low back pain as part of home therapy.
`M25.5`	Pain in joint	General joint pain diagnoses where adjunctive home modalities are used to manage symptoms.
`M79.1`	Myalgia	Diffuse muscle pain that may benefit from home-based therapeutic diathermy for symptom relief.
`M75.1`	Rotator cuff syndrome	Shoulder tendinopathies often receive home modality prescriptions when conservative measures are indicated.
`G89.29`	Other chronic pain	Chronic pain conditions managed with multimodal therapy, including home-use diathermy for symptom control.
`M70.6`	Prepatellar bursitis	Localized bursitis where therapeutic diathermy can be part of nonoperative management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97110`	Therapeutic exercises to develop strength and endurance, range of motion and flexibility	Often provided during clinic PT sessions before or alongside home diathermy prescription to document conservative care.
`97010`	Application of a modality to 1 or more areas; hot or cold packs	Frequently used in-clinic as an initial modality trial before prescribing a home ultrasonic diathermy device.
`97140`	Manual therapy techniques (e.g., mobilization/manipulation)	Used in evaluation and conservative care prior to issuing the home-use diathermy device.
`99070`	Supplies and materials (for DME-related patient education or single-use items)	Billed when additional supplies or educational materials accompany device delivery.
`99024`	Postoperative follow-up visit included in global service	Relevant when device prescription is part of postoperative management and follow-up visits are billed per payer rules.

HCPCS K1005: Disposable Breast Milk Collection and Storage Bag

HCPCS-K1006-HOME-SUCTION-PUMP-URINE-MANAGEMENT

HCPCS K1006: Home Suction Pump for External Urine Management

HCPCS-K1007-POWERED-BILATERAL-LOWER-EXTREMITY-ORTHOSIS

HCPCS Level II K1007: Powered Bilateral Lower‑Extremity Orthosis

HCPCS-K1009-SPEECH-VOLUME-MODULATION-SYSTEM

HCPCS K1009: Speech Volume Modulation System, All Components and Accessories

HCPCS-K1010-INDWELLING-INTRAURETHRAL-DRAINAGE-DEVICE-REPLACEMENT

HCPCS K1010: Indwelling Intraurethral Drainage Device, Replacement Only

HCPCS-K1011-ACTIVATION-DEVICE-INTRAURETHRAL-DRAINAGE-VALVE-REPLACEMENT

HCPCS Level II K1011: Activation Device for Intraurethral Drainage Valve

HCPCS-K1012-CHARGER-BASE-INTRAURETHRAL-ACTIVATION-DEVICE-REPLACEMENT

HCPCS K1012: Charger and Base for Intraurethral Activation Device, Replacement Only

HCPCS-K1013-ENEMA-TUBE-REPLACEMENT

HCPCS Level II K1013: Enema Tube, Replacement Only

HCPCS-K1014-ENDOSKELETAL-KNEE-SHIN-4-BAR-FLUID-CONTROL

HCPCS K1014: Endoskeletal Knee-Shin System with Fluid Swing/Stance Control

HCPCS-K1015-FOOT-ADDUCTUS-POSITIONING-DEVICE-ADJUSTABLE

HCPCS K1015: Foot Adductus Positioning Device, Adjustable

Showing 1–10 of 32

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS K1004: Low Frequency Ultrasonic Diathermy Device for Home Use

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Billing Code Overview

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HCPCS K1004: Low Frequency Ultrasonic Diathermy Device for Home Use

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

HCPCS K1004: Low Frequency Ultrasonic Diathermy Device for Home Use

Sign up for hcpcs K1004 policy alerts

Billing Code Overview

HCPCS K1004: Low Frequency Ultrasonic Diathermy Device for Home Use

Sign up for hcpcs K1004 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code K1004 represent?

What clinical documentation and workflow are expected before furnishing a K1004 device?

Which specialties and supplier taxonomies are commonly associated with prescribing or furnishing K1004?

Which modifiers are listed as relevant for billing K1004 and when are they used?

What related CPT or HCPCS codes are commonly billed alongside K1004?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code K1004 represent?

What clinical documentation and workflow are expected before furnishing a K1004 device?

Which specialties and supplier taxonomies are commonly associated with prescribing or furnishing K1004?

Which modifiers are listed as relevant for billing K1004 and when are they used?

What related CPT or HCPCS codes are commonly billed alongside K1004?

References