Understanding 97012 CPT Code for Effective Reimbursement

[This post was originally published on 6th January 2026. It has been updated on 19th February 2026.]

Mechanical traction remains a commonly used therapy in chiropractic care, especially for patients with disc-related conditions, radiculopathy, and nerve compression. Yet CPT code 97012 continues to be one of the most misunderstood chiropractic medical billing codes, frequently leading to denials, delayed payments, and post-payment audits.

In most cases, billing issues don’t occur because traction is clinically inappropriate, but because the service provided doesn’t meet the payer’s definition of mechanical traction. In 2026, as payers tighten documentation standards and modifier usage rules, understanding how to correctly bill 97012 is more important than ever.

This blog explains what CPT 97012 represents, how it differs from commonly confused services, and how to use chiropractic codes and modifiers correctly to reduce risk and improve reimbursement.

What is CPT code 97012 for chiropractic?

CPT code 97012 describes mechanical traction, a supervised physical medicine modality where a mechanical device applies controlled traction forces to one or more regions of the body.

97012 CPT code description as maintained by American Academy of Professional Coders, is a medical procedural code under the range – Supervised Physical Medicine and Rehabilitation Modalities. Techniques applied in mechanical traction are dependent on the patient’s condition, disorder, tolerance level, and the spinal level to be treated.

• It does not require one-to-one, constant attendance
• It must involve mechanically generated force, not manual effort
• It is typically billed as one unit per visit, regardless of body regions treated

From a chiropractic billing perspective, CPT code 97012 is separate from chiropractic manipulation codes (98940-98942) and must be justified independently through documentation and medical necessity.

Key Characteristics of CPT 97012

When billing for chiropractic services using 97012, all of the following must be true:

• A mechanical or electromechanical traction device is used
• The traction applies a controlled pulling force
• The service is supervised, not continuously attended
• Documentation supports medical necessity and patient response

Failure to meet any of these criteria can result in denials, especially when payers review claims using updated chiropractic CPT codes and modifiers guidelines for 2026.

What Is Mechanical Traction?

Mechanical traction is a supervised therapy modality designed to:

• Reduce nerve root compression
• Decrease disc pressure
• Increase intervertebral space
• Improve patient function and reduce pain

Traction may be delivered as intermittent traction, or continuous (static) traction, using a mechanical system.

Common clinical indications include:

• Cervical or lumbar radiculopathy
• Herniated or bulging discs
• Degenerative disc disease
• Neck, back, arm, or leg pain

Clinical effectiveness alone is not enough, billing for chiropractic services requires that mechanical traction be clearly documented as medically necessary and distinct from manipulation.

Who Can Perform Mechanical Traction?

In most states, licensed chiropractors may perform mechanical traction. In some jurisdictions, trained Chiropractic Assistants (CAs) may apply traction under supervision, subject to:

• State scope-of-practice laws
• Chiropractic board regulations
• Payer-specific supervision rules

Key supervision rules:

• The chiropractor must be present in the office suite
• The provider does not need to be in the same room
• Delegation must be properly documented

Improper supervision is a common reason for denials, even when the correct chiropractic medical billing codes are used.

When CPT 97012 is Appropriate to Bill

CPT 97012 should be reported only when true mechanical traction is provided and all supervision and documentation requirements are met. Understanding when this code applies helps reduce denials and ensures compliant billing for chiropractic services.

Key conditions for proper use include:

• Mechanical traction only
  CPT 97012 applies exclusively to traction delivered by a mechanical or electromechanical device that applies a controlled pulling force. Manual traction techniques, body-weight methods, and roller tables do not meet the CPT definition and should not be billed under this code.
• Supervised (not constant attendance) modality
  Mechanical traction is classified as a supervised physical medicine modality. The provider must be available in the office suite and responsible for patient safety and proper setup, but continuous, one-to-one contact during the entire treatment is not required.
• Clear setup and monitoring responsibility
  The practitioner (or appropriately supervised staff, where permitted) must ensure correct positioning, appropriate device settings, and patient tolerance throughout the session.
• Treatment duration should be documented
  Although CPT 97012 is not a time-based code and is typically billed as one unit per visit, documenting start/end time or total treatment duration supports medical necessity and helps defend claims during audits or payer reviews.

CPT 97012 is appropriate only when a mechanical traction device is used, supervision requirements are met, and documentation clearly supports why traction was necessary as part of the patient’s treatment plan.

Source

Services Commonly Mistaken for CPT 97012

One of the most frequent compliance issues in chiropractic billing occurs when services that look like traction are incorrectly billed as mechanical traction.

Roller Table Therapy

Roller tables rely on gravity and patient movement, not a mechanical pulling force. Most payers, including Medicare, do not recognize roller tables as mechanical traction.

• CPT 97012 should not be used
• Some payers may allow unlisted code 97039, but only with verification

Static Traction Blocks or Positioning Wedges

These tools assist with positioning but do not generate mechanical traction force. Billing CPT 97012 in these cases is inappropriate and frequently denied.

Flexion-Distraction Technique

Flexion-distraction is a manual, provider-performed technique and is generally considered part of chiropractic manipulation.

Billing CPT 97012 alongside manipulation codes is often viewed as unbundling, increasing audit risk and recoupments.

Medicare and CMS Guidance on CPT 97012 (Mechanical Traction)

Medicare’s coverage framework considers CPT code 97012 (mechanical traction) a valid therapy modality when medically necessary and thoroughly documented within the context of a defined treatment plan. Mechanical traction, as described in CMS and Medicare policy, must meet specific therapy and documentation requirements to be payable under Part B.

Medicare Coverage Highlights

According to CMS supportive documentation requirements for therapy services, CPT 97012:

• Is accepted as a covered modality when justified as part of a medically necessary treatment program. 
• Is generally limited to one unit per date of service, regardless of the number of body areas treated. 
• Must be performed in accordance with the definition of mechanical traction and supported by clinical necessity. 

These principles are consistent with CMS’s documentation guidelines for therapy modalities and are reflected in the official Medicare Coverage Database (MCDB) and related CMS manual language. You can explore more on Medicare’s coverage policies at the official CMS site here.

Documentation Requirements for Reimbursement

Medicare requires that records clearly support the necessity and appropriateness of CPT 97012. Clinical documentation should include:

• Diagnosis and etiology: A clear clinical diagnosis justifying the need for mechanical traction. 
• Device details: The type of traction device used to ensure it meets the definition of mechanical traction rather than manual methods or non-covered equipment. 
• Body region treated: Which anatomical area was treated (e.g., cervical, lumbar). 
• Treatment timing: While 97012 isn’t strictly a timed code, stating start and end times or duration supports medical necessity and payer review. 
• Patient response and progress: Clinical notes should reflect how the patient responded to traction, progress toward goals, and justification for continued use. 

Completeness and clarity in documentation are crucial because Medicare and other payers rely on your record to determine whether the service was reasonable and necessary.

What Medicare Does Not Cover

CMS policy explicitly states that certain advanced spinal decompression systems, such as VAX-D or DRX tables, are not recognized as covered mechanical traction modalities under Medicare’s National Coverage Determinations. Attempts to bill these services under CPT 97012 typically result in denials because they do not meet the defined criteria for mechanical traction.

In such cases, providers may consider using an unlisted modality code (e.g., CPT 97039) if the service is appropriately justified and payer policies allow it, but additional documentation and potentially Advanced Beneficiary Notice (ABN) procedures may be required.

Key Points to Remember

• Only true mechanical traction qualifies under Medicare; non-mechanical approaches should never be billed as CPT 97012. 
• Proper documentation and alignment with Medicare’s therapy coverage rules mitigate the risk of denials or post-payment reviews. 
• Providers should periodically verify coverage updates via the CMS Medicare Coverage Database (MCBD) and local Medicare Administrative Contractor (MAC) guidance for the most current policies.

Medicare’s official outpatient therapy guidance confirms several key points:

Covered Use

• Mechanical traction is accepted as a therapy modality when documented as medically necessary and part of a therapy plan for spinal pain or radiculopathy.
• Only 1 unit of 97012 is generally payable per date of service, even if multiple body areas are treated. 

Does CPT 97012 require a modifier in 2026?

Correct modifier use is essential when billing CPT 97012 alongside other services.

Common chiropractic modifier codes include:

• Modifier 59 / XU / XE / XS – When traction is distinct from other same-day services
• Modifier GP – Indicates a therapy plan of care (required by some commercial payers). For instance, when billing 97012 to BCBSNC and NC State Health Plan (SHP), you must append 97012 with modifier GP. 
• Modifier GA / GY – Used when services are expected to be non-covered by Medicare

Modifier rules vary significantly by payer. In 2026, incorrect modifier usage remained one of the top denial triggers in chiropractic CPT codes and modifiers audits.

As payer scrutiny continues to increase in 2026, billing CPT 97012 correctly requires more than just performing traction, it demands clear alignment with payer policy, documentation standards, and appropriate use of chiropractic codes and modifiers. Following these best practices can significantly reduce denials and post-payment audits.

• Confirm payer coverage before treatment
  Coverage for mechanical traction varies by carrier. Always verify whether the payer recognizes CPT 97012 as a covered modality, any unit limitations, and required chiropractic modifier codes before initiating care.
• Clearly identify the modality used
  Documentation must explicitly state that a mechanical traction device was used. Avoid vague terms like decompression or traction therapy, which can trigger denials or audits when reviewing chiropractic medical billing codes.
• Do not bill CPT 97012 for non-qualifying services
  Manual traction, roller tables, gravity-based systems, and positioning devices do not meet CPT requirements. Billing these under 97012 is one of the most common errors in billing for chiropractic services.
• Tie diagnoses to functional limitations
  Use ICD-10 codes that clearly support medical necessity and connect traction to measurable functional deficits such as radiculopathy, reduced mobility, or pain impacting daily activities.
• Monitor and document patient response over time
  Payers increasingly expect progress tracking. Notes should reflect tolerance, symptom changes, and why continued mechanical traction remains clinically appropriate.
• Apply chiropractic modifiers accurately and consistently
  Modifiers such as GP, 59, XU, GA, or GY must be used correctly based on payer rules. Incorrect use of chiropractic modifiers 2026 standards is a leading cause of claim rejections.

Strong, payer-aligned documentation is the foundation of compliant chiropractic billing. When CPT 97012 is billed with precision, supported by medical necessity, and paired with correct chiropractic CPT codes and modifiers, clinics are far better positioned to protect revenue and withstand payer review in 2026.

[Read More: In-House Chiropractic Billing Or Outsource It – That’s A Million Dollar Question!]

Quick Summary: What CPT 97012 Represents

Aspect	Key Point
Code Use	Mechanical traction (supervised, non-constant attendance)
Coverage	Generally covered if medically necessary and properly documented
Units	1 per date of service
Not Covered	Manual traction, roller tables, spinal decompression devices
Modifiers	59/XU/GP/GY/GA depending on circumstances

Conclusion

A Smarter Way to Manage Chiropractic Billing

Navigating chiropractic codes and modifiers, especially nuanced codes like CPT 97012, can drain time and increase compliance risk. That’s where zHealth can help.

zHealth’s managed billing services support clinics by:

• Reviewing chiropractic medical billing codes
• Applying correct chiropractic modifiers for 2026
• Submitting clean, compliant claims
• Managing denials and appeals
• Improving cash flow and reimbursement confidence

With expert oversight and smarter workflows, clinics spend less time worrying about billing, and more time focused on patient care.

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A Complete Guide to Chiropractic Billing and Coding

The ‘Tricky’ 97140 Chiropractic CPT Code: How to Use This Code Appropriately

Know the Top Chiropractic CPT Codes That Can Save Your Billing Time