AcupunctureCPT 9781416 states

How much does insurance pay for CPT 97814?

Acupuncture, with electrical stimulation; each additional 15 minutes. Anonymized historical insurance payments by state, from claims processed through Soundry.

Quick answer

Across the 16 states with published Soundry benchmarks, the median insurance payment for CPT 97814 (acupuncture w/ e-stim, additional 15 min) ranges from $0 in Georgia to $70 in South Dakota. Payment depends on the state, payer, and plan.

CPT 97814 insurance payments by state

Paid amounts are what insurers paid after patient cost sharing. The middle 50% shows the range between the 25th and 75th percentile.

StateMedian paidMiddle 50% paidMedian allowedSample
Arkansas$27$27 – $27$27100–249 claims
Colorado$44$44 – $44$44fewer than 50 claims
Florida$29$0 – $80$70250+ claims
Georgia$0$0 – $25$5050–99 claims
Illinois$30$22 – $31$31100–249 claims
Louisiana$27$27 – $27$2750–99 claims
Maryland$49$49 – $53$51fewer than 50 claims
Massachusetts$35$35 – $50$35250+ claims
Nebraska$70$53 – $145$70fewer than 50 claims
New York$70$70 – $145$70250+ claims
Oregon$57$46 – $62$57250+ claims
Pennsylvania$51$35 – $71$71fewer than 50 claims
South Dakota$70$70 – $70$70fewer than 50 claims
Texas$27$27 – $27$27250+ claims
Virginia$0$0 – $0$44fewer than 50 claims
Wisconsin$40$0 – $69$61fewer than 50 claims

How CPT 97814 is billed

Acupuncture is billed in 15-minute units of personal one-on-one contact: an initial code (97810, or 97813 with electrical stimulation) followed by add-on codes (97811 or 97814) for each additional 15 minutes. Many plans cap the number of covered visits per year.

Frequently asked questions

How much does insurance pay for CPT 97814?+

Across the 16 states with published Soundry benchmarks, the median insurance payment for CPT 97814 (acupuncture w/ e-stim, additional 15 min) ranges from $0 in Georgia to $70 in South Dakota. Payment depends on the state, payer, and plan.

How is CPT 97814 billed?+

Acupuncture is billed in 15-minute units of personal one-on-one contact: an initial code (97810, or 97813 with electrical stimulation) followed by add-on codes (97811 or 97814) for each additional 15 minutes. Many plans cap the number of covered visits per year.

Where do these numbers come from?+

They are anonymized, aggregated insurance payments from claims processed through Soundry. A state is published only when it has enough claims from multiple practices, and individual practices, payer contracts, and claims are never shown.

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