CommercialBilling CodesHigh impact
Reimbursement Update: Massage Therapy CPT Code 97124
Highmark·PA, NY, DE, WV · Chiropractic, Physical Therapy, Occupational Therapy +1 more·Coding
Effective date
Oct 26, 2026
We identified it
Jul 28, 2026
Summary
Effective October 26, 2026, Highmark will no longer separately reimburse CPT code 97124 (massage therapy) when billed by providers in Chiropractic, Physical Therapy, Occupational Therapy, and Physiatry specialties. Claims with this code from these specialties will be denied as non-separately reimbursed. This change applies to Commercial and Medicare Advantage plans; massage therapists billing as rendering providers are not affected.
Action Required
Before October 26, 2026: (1) Billing team must update billing software to deny or flag CPT 97124 claims submitted by Chiropractic, Physical Therapy, Occupational Therapy, and Physiatry providers on Highmark Commercial and Medicare Advantage plans. (2) Providers in these specialties must stop billing CPT 97124 separately; bundle this service into other billable codes or unbundle into component services as appropriate. (3) Review and update encounter templates and provider education materials to reflect this change. (4) Providers should verify documentation supports CPT 97140 (manual therapy) billing if applicable, as this code remains separately reimbursable when clinically documented. (5) Monitor rejected claims post-implementation for compliance. Failure to implement these changes will result in automatic claim denials for CPT 97124 from affected specialties, creating revenue leakage and potential member billing issues.