Quick reference · CPT cheat sheet
You know what happened in the room. This turns it into codes: which one applies, how your minutes become units, and the rules that trip people up. Keep it open while you write the superbill.
Everything else on this page builds on these. Search every other code further down.
| Code | In plain words | E-stim? | Which unit | Needs a new needle set? |
|---|---|---|---|---|
| 97810 | Needling, first 15 minutes of one-on-one time | No | First unit | No |
| 97811 | Each further 15 minutes of one-on-one time | No | Add-on to 97810 or 97813 | Yes |
| 97813 | Needling with electrical stimulation, first 15 minutes | Yes | First unit | No |
| 97814 | Each further 15 minutes of one-on-one time | Yes | Add-on to 97810 or 97813 | Yes |
Think of your last treatment. Four things you already know decide the code, and a fifth decides whether it holds up.
Without it, you are in 97810 and 97811. With it (current passed through at least one pair of needles), you are in 97813 and 97814.
Count face-to-face time, not needle time. The first unit (97810 or 97813) is for the first 15 minutes of one-on-one contact. Common practice, often called the 8-minute or midpoint rule, treats a unit as earned once you pass halfway, so 8 minutes earns the first one. Under 8 minutes, nothing is billed.
Write it in the noteFace-to-face time: 38 minutes. Needles in place 20 minutes.
Each additional 15 minutes is billed with the add-on code (97811 or 97814), but those codes are defined “with re-insertion of needle(s)”. Without a new set, bill the first unit only, however long the visit ran. See the note below.
A same-day consultation usually needs modifier 25. Herbs, massage and cupping each work differently: see the code finder below.
Each line needs a code, units and a diagnosis the plan can match. Pick yours from the acupuncture ICD-10 list.
The needling codes, the consultation codes and the others that often end up on a superbill. Search a code or a word, filter by type, and open one for what it is, how many units, and what to watch for.
22 codes
Acupuncture, no e-stim, first 15 min
Acupuncture, without electrical stimulation, first 15 minutes of one-on-one contact.
Add-on, no e-stim, each added 15 min
Without electrical stimulation, each additional 15 minutes, with re-insertion of needle(s).
Acupuncture with e-stim, first 15 min
Acupuncture, with electrical stimulation, first 15 minutes of one-on-one contact.
Add-on, e-stim, each added 15 min
With electrical stimulation, each additional 15 minutes, with re-insertion of needle(s).
New patient, straightforward
New patient, straightforward medical decision-making. The lowest new-patient level.
New patient, low complexity
New patient, low medical decision-making. The usual initial consultation for an acupuncture practice.
New patient, moderate complexity
New patient, moderate medical decision-making. For a more complex first evaluation.
Established patient, straightforward
Established patient, straightforward medical decision-making. The lowest established-patient level.
Established patient, low complexity
Established patient, low medical decision-making. The usual review consultation.
Established patient, moderate complexity
Established patient, moderate medical decision-making. Commonly used for evaluating and managing an herbal prescription.
Preventive visit, infants (under 1)
A comprehensive preventive visit for infants (under 1): 99381 for a new patient, 99391 for an established one. The age on the date of service picks the pair.
Preventive visit, ages 1 to 4
A comprehensive preventive visit for ages 1 to 4: 99382 for a new patient, 99392 for an established one. The age on the date of service picks the pair.
Preventive visit, ages 5 to 11
A comprehensive preventive visit for ages 5 to 11: 99383 for a new patient, 99393 for an established one. The age on the date of service picks the pair.
Preventive visit, ages 12 to 17
A comprehensive preventive visit for ages 12 to 17: 99384 for a new patient, 99394 for an established one. The age on the date of service picks the pair.
Preventive visit, ages 18 to 39
A comprehensive preventive visit for ages 18 to 39: 99385 for a new patient, 99395 for an established one. The age on the date of service picks the pair.
Preventive visit, ages 40 to 64
A comprehensive preventive visit for ages 40 to 64: 99386 for a new patient, 99396 for an established one. The age on the date of service picks the pair.
Preventive visit, ages 65 and over
A comprehensive preventive visit for ages 65 and over: 99387 for a new patient, 99397 for an established one. The age on the date of service picks the pair.
Herbal formulas dispensed
The only generic code for the herbs themselves, and it is rarely covered.
Massage, per 15 min
Massage, each 15 minutes, billed by units of time.
Manual therapy, per 15 min
Mobilization or manual techniques, each 15 minutes.
Infrared
The infrared code.
Cupping (vasopneumatic device)
There is no code specific to cupping. The evidence that 97016 covers it comes from VA Community Care.
| Code | What it is | Units | Watch for |
|---|---|---|---|
| 97810 | Acupuncture, no e-stim, first 15 min. Acupuncture, without electrical stimulation, first 15 minutes of one-on-one contact. | 1 unit once face-to-face time passes 8 minutes | Under 8 minutes bills nothing. A longer visit with the same needles is still one unit. |
| 97811 | Add-on, no e-stim, each added 15 min. Without electrical stimulation, each additional 15 minutes, with re-insertion of needle(s). | One per further 15 minutes, up to what the visit's time supports | Needs a new needle set, noted in the chart. Extra time with the same needles does not count. |
| 97813 | Acupuncture with e-stim, first 15 min. Acupuncture, with electrical stimulation, first 15 minutes of one-on-one contact. | 1 unit once face-to-face time passes 8 minutes | Bill one modality family per visit. If you did both, ask the payer how to report it. |
| 97814 | Add-on, e-stim, each added 15 min. With electrical stimulation, each additional 15 minutes, with re-insertion of needle(s). | One per further 15 minutes, up to what the visit's time supports | Needs a new needle set, noted in the chart. Record the positions and the time on each set. |
| 99202 | New patient, straightforward. New patient, straightforward medical decision-making. The lowest new-patient level. | 1 | The level has to be supported by the note. |
| 99203 | New patient, low complexity. New patient, low medical decision-making. The usual initial consultation for an acupuncture practice. | 1 | Without modifier 25 it is often denied as bundled into the acupuncture. Some payers do not pay a same-day consultation at all. |
| 99204 | New patient, moderate complexity. New patient, moderate medical decision-making. For a more complex first evaluation. | 1 | Do not default to the higher level. The note has to show the work behind it. |
| 99212 | Established patient, straightforward. Established patient, straightforward medical decision-making. The lowest established-patient level. | 1 | A full consultation is not meant for every visit. |
| 99213 | Established patient, low complexity. Established patient, low medical decision-making. The usual review consultation. | 1 | One billing source suggests roughly once a month unless there is a new diagnosis or a significant change. |
| 99214 | Established patient, moderate complexity. Established patient, moderate medical decision-making. Commonly used for evaluating and managing an herbal prescription. | 1 | Your state's scope of practice has to include herbal prescribing, and the note has to support the level. |
| 99381 / 99391 | Preventive visit, infants (under 1). A comprehensive preventive visit for infants (under 1): 99381 for a new patient, 99391 for an established one. The age on the date of service picks the pair. | 1 | Written for a comprehensive preventive exam, not a treatment visit. Whether a payer accepts it from an acupuncturist varies, and many treat it as patient-pay. Ask first. |
| 99382 / 99392 | Preventive visit, ages 1 to 4. A comprehensive preventive visit for ages 1 to 4: 99382 for a new patient, 99392 for an established one. The age on the date of service picks the pair. | 1 | Written for a comprehensive preventive exam, not a treatment visit. Whether a payer accepts it from an acupuncturist varies, and many treat it as patient-pay. Ask first. |
| 99383 / 99393 | Preventive visit, ages 5 to 11. A comprehensive preventive visit for ages 5 to 11: 99383 for a new patient, 99393 for an established one. The age on the date of service picks the pair. | 1 | Written for a comprehensive preventive exam, not a treatment visit. Whether a payer accepts it from an acupuncturist varies, and many treat it as patient-pay. Ask first. |
| 99384 / 99394 | Preventive visit, ages 12 to 17. A comprehensive preventive visit for ages 12 to 17: 99384 for a new patient, 99394 for an established one. The age on the date of service picks the pair. | 1 | Written for a comprehensive preventive exam, not a treatment visit. Whether a payer accepts it from an acupuncturist varies, and many treat it as patient-pay. Ask first. |
| 99385 / 99395 | Preventive visit, ages 18 to 39. A comprehensive preventive visit for ages 18 to 39: 99385 for a new patient, 99395 for an established one. The age on the date of service picks the pair. | 1 | Written for a comprehensive preventive exam, not a treatment visit. Whether a payer accepts it from an acupuncturist varies, and many treat it as patient-pay. Ask first. |
| 99386 / 99396 | Preventive visit, ages 40 to 64. A comprehensive preventive visit for ages 40 to 64: 99386 for a new patient, 99396 for an established one. The age on the date of service picks the pair. | 1 | Written for a comprehensive preventive exam, not a treatment visit. Whether a payer accepts it from an acupuncturist varies, and many treat it as patient-pay. Ask first. |
| 99387 / 99397 | Preventive visit, ages 65 and over. A comprehensive preventive visit for ages 65 and over: 99387 for a new patient, 99397 for an established one. The age on the date of service picks the pair. | 1 | Written for a comprehensive preventive exam, not a treatment visit. Whether a payer accepts it from an acupuncturist varies, and many treat it as patient-pay. Ask first. |
| A9150 | Herbal formulas dispensed. The only generic code for the herbs themselves, and it is rarely covered. | Tell patients up front that it is likely out of pocket, and print it marked patient responsibility so it is not a surprise. | |
| 97124 | Massage, per 15 min. Massage, each 15 minutes, billed by units of time. | By time, each 15 minutes | Payers often bundle it with acupuncture. Check yours before assuming it is payable on the same visit. |
| 97140 | Manual therapy, per 15 min. Mobilization or manual techniques, each 15 minutes. | By time, each 15 minutes | Payer edits commonly bundle it with the acupuncture codes. Check your payer first. |
| 97026 | Infrared. The infrared code. | Check the payer before adding it to a superbill. | |
| 97016 | Cupping (vasopneumatic device). There is no code specific to cupping. The evidence that 97016 covers it comes from VA Community Care. | Most other payers do not pay for cupping, so many practices charge for it as a cash-pay line. |
Fourteen codes, but only two questions pick one: is this a new or an established patient, and how old are they on the date of service?
| Patient’s age | New patient | Established |
|---|---|---|
| infants (under 1) | 99381 | 99391 |
| 1 to 4 | 99382 | 99392 |
| 5 to 11 | 99383 | 99393 |
| 12 to 17 | 99384 | 99394 |
| 18 to 39 | 99385 | 99395 |
| 40 to 64 | 99386 | 99396 |
| 65 and over | 99387 | 99397 |
Tick what happened and see the lines that would go on the superbill. The needling lines use the same rule Goji does.
Lines for the superbill
The time would support more units, but only with a new needle set. Tick it if you used one and noted it.
An example, not billing advice. Each code opens in the finder above.
The most units that face-to-face time can support. Only the first is yours without a new needle set.
1 unit: the first-unit code (97810 or 97813).
1 unitUp to 2 units: the first-unit code plus 1 of the add-on code, if a new needle set was used.
2 unitsUp to 3 units: the first-unit code plus 2 of the add-on code, if a new needle set was used.
3 unitsUp to 4 units: the first-unit code plus 3 of the add-on code, if a new needle set was used.
4 unitsPatterns from billing guides, not any one payer’s policy.
Goji suggests 97810 or 97813 from the visit’s recorded minutes and whether electrical stimulation was used. Add-on units are off by default and can be turned on in Settings, Billing. Goji never submits a claim; the superbill goes to the patient. See billing and the invoicing docs.
Sources: AAPC Codify: CPT 97810, Acupuncture Today: Billing for additional sets of needles, Acupuncture Today: Billing and time matters, Acupuncture Today: How to bill evaluation and management codes (about every 30 days), Blue Cross of Vermont: acupuncture payment policy (modifier 25), California Medical Association: CPT reporting for preventive medicine services (age bands, established patient, modifier 25), UnitedHealthcare: acupuncture reimbursement policy (units, supplies), Premera: acupuncture payment policy (daily limits, dry needling), Acupuncture Today: The most common modifier for acupuncture claims.
Electrical stimulation. 97810 is acupuncture without it and 97813 is acupuncture with it, and each covers the first 15 minutes of one-on-one time. You report one or the other for the first unit, never both on the same day. The 97813 code says “one or more needles”, so stimulating a single needle is generally enough; record which points and for how long.
Up to two: the first-unit code (97810 or 97813) plus one add-on (97811 or 97814), and the add-on only if you needled a new set. With one set of needles it is one unit. Count face-to-face minutes, not how long the needles stayed in. Under common practice 8 minutes earns the first unit and 23 the second, though payers can round differently.
Usually not. Those two add-on codes are defined “with re-insertion of needle(s)”, which billing guidance reads as a new needle set, for example after turning the patient over. A 60-minute visit with a single set is normally one unit of 97810 or 97813. Confirm with each payer, and document the second set in the note.
Usually yes. A consultation (E/M) billed the same day as needling is often denied as bundled into the acupuncture unless it carries modifier 25, written 99203-25. The note has to show a significant, separately identifiable service, and some payers do not pay a same-day consultation at all. Check each payer.
Two common cases. Dry needling: Premera’s payment policy denies acupuncture lines when needle insertion (20560 or 20561) is billed for the same date, with no modifier to override it. Needles: UnitedHealthcare’s policy includes needle supplies (A4212, A4215) in the acupuncture service and denies them if submitted separately. Check how your payers treat each.
No CPT code is specific to either. Some sources point to 97016 for cupping, but the evidence is specific to VA Community Care. Many practices charge for cupping and moxibustion as a cash-pay add-on instead of using an unlisted-procedure code, which payers usually want a written policy and a description for.
Not automatically. A code describes what you did; it does not mean a plan pays for it. Coverage, visit limits and which diagnoses qualify are each plan’s decision, and Medicare and Medicaid have their own rules. Patients should check with their plan, and you should check with the payers you bill.
Goji suggests the first-unit code (97810 or 97813) from the visit’s recorded minutes and whether electrical stimulation was used. Add-on units are off by default, because the chart has no way to confirm a new needle set. You can turn them on under Settings, Billing if you record that yourself and your payers accept it.
Goji suggests the code and units from the visit’s recorded time and puts them on the superbill. Start free and see one.