CPT 2026 · Physical Medicine

CPT 97039

Global XXX

Unlisted modality

Effective 2026-04-01 Conv. factor $33.4009
No national RVU
Payment Methodology
C
Status Indicator
10
NCCI Partners
XXX
Global Period
No national RVU

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

CPT 97039 Billing & Documentation Guide

CPT code 97039 (Unlisted modality) is classified under Physical Medicine with a global period indicator of XXX. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.

When billing 97039, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 97039 with related codes; this code has 10 PTP bundling relationships on file (see table below).

Payment Status & Global Period

CMS Status Indicator
C

Carrier-priced (MAC determines payment locally)

Global Period
XXX

No global period (E/M and other non-procedural services)

MUE Limit (Medically Unlikely Edits)

Max units per beneficiary per date of service
1
Rationale: Clinical: Data
Adjudication: Date of Service (Clinical)
Source: CMS NCCI MUE Practitioner Services, effective 2026-04-01.

Submitting more than 1 units of 97039 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.

NCCI Bundling Edits, CPT 97039

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 97039 on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code Relationship Modifier Allowed Rationale
0213T Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
0216T Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
0228T Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
0229T Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
0230T Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
0231T Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
36591 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
36592 Column 1 (primary), can be billed with modifier No CPT Manual or CMS manual coding instruction
62310 Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code
62311 Column 1 (primary), can be billed with modifier Yes Misuse of Column Two code with Column One code

Frequently Asked Questions, CPT 97039

What does CPT code 97039 mean? +

CPT code 97039 represents: Unlisted modality. It's in the Physical Medicine category with a global period of XXX.

What is the Medicare reimbursement for CPT 97039? +

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

What modifiers can I use with CPT 97039? +

Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.

What bundling edits apply to CPT 97039? +

This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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