Practice management

Acupuncture CPT Codes & ICD-10 Billing Guide

A practical reference for licensed acupuncturists in the US: the CPT codes payers actually accept, how to pair them with ICD-10 diagnoses, and how those ICD-10 codes map to the TCM patterns you're already treating.

Common CPT codes for acupuncture practice

Code	Descriptor	Notes
97810	Acupuncture, 1 or more needles; initial 15 min of personal one-on-one contact, without electrical stimulation	Bill once per visit. Time-based — face-to-face contact must reach at least 8 minutes.
97811	Acupuncture; each additional 15 min, with re-insertion of needles, without electrical stimulation	Add-on to 97810. Requires re-insertion in the new 15-minute block, not just retention.
97813	Acupuncture, 1 or more needles; initial 15 min, with electrical stimulation	Use in place of 97810 when e-stim is delivered. Document leads, frequency, and duration.
97814	Acupuncture; each additional 15 min, with e-stim and re-insertion of needles	Add-on to 97813. Same re-insertion requirement.
97016	Application of a modality; vasopneumatic devices (cupping)	Most common code payers accept for cupping. Some payers prefer 97139 (unlisted therapeutic procedure) — check the payer's policy.
97026	Application of a modality; infrared (moxibustion, heat lamps)	Frequently used for indirect moxa and TDP lamp. Not universally reimbursed — document therapeutic intent.
97124	Therapeutic procedure; massage (tui na, gua sha)	Time-based (15 min units). Requires direct one-on-one contact and cannot be billed on the same region as 97140.
97140	Manual therapy techniques (e.g. tui na, myofascial release)	Time-based. Modifier 59 typically required when billed with 97810/97813 on the same date.
97110	Therapeutic exercise (qi gong, tai chi instruction)	Time-based. Document specific exercises, sets/reps, and functional goal.
97112	Neuromuscular re-education	Useful for post-stroke, Bell's palsy, or vestibular scalp acupuncture cases. Document neuro deficits addressed.
99202–99205	New patient evaluation & management (E/M)	Only bill when a separately identifiable evaluation occurs. Modifier 25 required if billed with acupuncture on the same day.
99212–99215	Established patient E/M	Same rules. Note-writing should clearly separate the E/M work from the treatment.

Time-based billing at a glance

97810/97813 covers the first 15 minutes of one-on-one contact. Only one initial code per date of service.
97811/97814 requires re-insertion of needles in the additional 15-minute block — needle retention alone doesn't qualify.
The 8-minute rule applies: bill an additional unit once you exceed 8 minutes into the next 15-minute block.
Document start and end times for every timed code. Payers audit this aggressively.

ICD-10 to TCM pattern mapping

The Western diagnosis on the claim form doesn't have to erase your TCM reasoning. Below are common ICD-10 codes acupuncturists submit, with the TCM patterns that typically underlie them and point selections most practitioners reach for.

ICD-10	Western diagnosis	TCM patterns	Common points
M79.1	Myalgia (muscle pain, unspecified region)	Qi and Blood stagnation in the channels Cold-Damp obstruction Liver Qi stagnation	Ashi points, LI4, LR3, GB34, local trigger points
M54.5	Low back pain	Kidney deficiency Cold-Damp Bi Qi and Blood stagnation from injury	BL23, BL40, GV4, KI3, BL25
M54.2	Cervicalgia (neck pain)	Wind-Cold invasion Liver Yang rising Local Qi and Blood stagnation	GB20, GB21, SI3, BL10, LI4
M25.511	Pain in right shoulder	Wind-Damp Bi Local channel stagnation Liver Qi stagnation	LI15, SI9, SI10, TE14, LI11
G43.909	Migraine, unspecified, not intractable	Liver Yang rising Wind-Phlegm Blood deficiency	GB20, GB8, TE5, LR3, GV20
R51.9	Headache, unspecified	Qi deficiency Blood stagnation External Wind	GV20, GB20, Yintang, LI4, ST8
F41.1	Generalized anxiety disorder	Heart and Spleen deficiency Liver Qi stagnation Heart-Kidney disharmony	HT7, PC6, Yintang, GV20, KI3, SP6
F32.9	Major depressive disorder, unspecified	Liver Qi stagnation Spleen Qi deficiency Heart Blood deficiency	LR3, LI4 (Four Gates), HT7, SP6, GV20
G47.00	Insomnia, unspecified	Heart Blood deficiency Liver Fire Heart-Kidney disharmony	HT7, PC6, Yintang, Anmian, SP6, KI3
K59.00	Constipation, unspecified	Large Intestine heat Qi stagnation Blood or Yin deficiency	ST25, SP15, TE6, ST36, KI6
N95.1	Menopausal and perimenopausal symptoms	Kidney Yin deficiency with empty Heat Liver Yang rising Heart-Kidney disharmony	KI3, SP6, HT7, LR3, GV20
N94.6	Dysmenorrhea, unspecified	Qi and Blood stagnation Cold in the uterus Liver Qi stagnation	SP6, SP8, CV4, CV6, LR3
J30.9	Allergic rhinitis, unspecified	Lung Qi deficiency with Wind invasion Kidney Yang deficiency	LI20, Yintang, LI4, BL13, ST36
J45.909	Unspecified asthma, uncomplicated	Lung and Kidney deficiency Phlegm obstruction Wind-Cold or Wind-Heat	LU7, LU9, KI3, BL13, Dingchuan
T14.90XA	Injury, unspecified, initial encounter	Acute Qi and Blood stagnation from trauma	Ashi points, LI4, LR3, local drainage points

Frequently asked questions

Which CPT codes should I bill for a standard acupuncture visit?

For a 30-minute session without electrical stimulation, most practitioners bill 97810 for the first 15 minutes of face-to-face contact and 97811 for the second 15-minute block (with needle re-insertion). If electrical stimulation is used, swap in 97813 and 97814 instead. Only one of the pairs 97810/97811 or 97813/97814 can be billed per date of service.

How do I bill an evaluation on the same day as acupuncture?

Append modifier 25 to the E/M code (e.g. 99203-25) when a separately identifiable evaluation is performed on the same day as 97810 or 97813. The chart note must clearly separate the E/M work (history, exam, medical decision-making) from the treatment.

Does Medicare cover acupuncture?

Medicare covers acupuncture only for chronic low back pain (defined as >12 weeks) under ICD-10 M54.5, and only when delivered by a physician, PA, NP, or CNS — or by an auxiliary provider under their direct supervision. Licensed acupuncturists are not currently recognised Medicare providers. Always verify the current LCD before billing.

What ICD-10 code covers a generic 'pain' complaint?

Avoid unspecified codes when a specific site is documented. Use M54.5 for low back pain, M54.2 for neck pain, M25.5xx for joint pain (with laterality), or M79.1 for myalgia when the region truly isn't specified. Payer denials are common on R52 (pain, unspecified).

Can I bill cupping and moxibustion separately?

Cupping is most commonly billed under 97016 (vasopneumatic devices) — some payers require 97139 instead. Moxibustion often falls under 97026 (infrared), though reimbursement is inconsistent. Both are typically bundled by payers on the same date as 97810/97811 unless the payer contract explicitly allows separate reimbursement.

How does Medi-Chi help with billing?

Medi-Chi's diagnostic engine produces a Western working impression alongside the TCM pattern, which speeds up ICD-10 selection during charting. The clinical handouts and treatment plans are structured so the documentation supports the CPT time-based billing rules (time in/out, techniques used, response to treatment).

Turn TCM reasoning into billable documentation

Medi-Chi generates a Western working impression alongside every TCM diagnosis, so your chart notes carry both an ICD-10-ready diagnosis and the pattern reasoning that justifies your point selection.

Try the diagnostic tool