CPT 97814 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Acupuncture Procedures |
| Common Place of Service | • 11 - Office • 49 - Independent Clinic |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 79 - Unrelated procedure - postop period |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 97814 |
National average reimbursement for CPT 97814 by major payers:
$39.35
$41.76
$42.12
$63.43
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 97814 | ||||||
United | 97814 | $32.04 | 1144267865 - NITIN PATEL | 462706345 | MO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97814 | $30.88 | 1437869229 - JASON LIOU | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 97814 | $60.00 | 1356352447 - MARLA HARTZEN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 97814 | $116.72 | 1275832438 - ADAM RAPPOPORT | 590634433 - THE NEMOURS FOUNDATION | FL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97814 | $74.02 | 1225211600 - JOHN MILLICHAP | 911352172 - MULTICARE HEALTH SYSTEM | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97814 | $49.47 | 1356608988 - TRIXIE LIPKE | 391157876 - BEAVER DAM COMMUNITY HOSPITALS INC | WI | Psychiatry Physician (2084P0800X) |
United | 97814 | $69.05 | 1144203753 - HAIDAR KABBANI | 383852646 - OSF MULTI-SPECIALTY GROUP | OH | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97814 | $94.20 | 1740252972 - DAVID HSU | 390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97814 | $44.65 | 1225211600 - JOHN MILLICHAP | 753186720 | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97814 | $60.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 97814 | $66.75 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | NC | Psychiatry Physician (2084P0800X) |
United | 97814 | $60.11 | 1194719534 - MARY BELFORD | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 97814 | $28.25 | 1013534106 - NATALIA CASTRO | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Family Nurse Practitioner (363LF0000X) |
United | 97814 | $57.45 | 1194719534 - MARY BELFORD | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 97814 | $68.30 | 1710244991 - ALBA PERGJIKA | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 97814 vs. Other Acupuncture Procedures Codes
The CPT 97814 code is part of the Medicine Services and Procedures services used for Acupuncture Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 97814 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 97804-CPT | Low | Medical Nutrition Therapy; Group (2 Or More Individuals), Each 30 Minutes |
| 97810-CPT | Low | Acupuncture, 1 Or More Needles; Without Electrical Stimulation, Initial 15 Minutes Of Personal One-On-One Contact With The Patient |
| 97811-CPT | Low | Acupuncture, 1 Or More Needles; Without Electrical Stimulation, Each Additional 15 Minutes Of Personal One-On-One Contact With The Patient, With Re-Insertion Of Needle(S) (List Separately In Addition To Code For Primary Procedure) |
| 97814-CPT | Low | Acupuncture 1 Or More Needles; With Electrical Stimulation Each Additional 15 Minutes Of Personal One-On-One Contact With The Patient Withre-Insertion Of Needle(S) (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97814. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97814 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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