Total Items
0
Laser Therapy FAQ 1 – Is Laser Therapy Covered By Insurance?
High-Intensity Laser Therapy, Cash Pay
April 7, 2017
Original 2017 contribution by Mark Callanen, PT, DPT, OCS. Coverage and coding update: October 16, 2026.
Insurance coverage for laser therapy is not automatic. Check the patient's benefit plan, the payer's current policy, the indication and the service before discussing reimbursement or patient payment. A procedure code does not, by itself, establish coverage.1,2
Check the applicable coverage policy
For Medicare, review the applicable national and local coverage requirements and the guidance from the practice's Medicare Administrative Contractor (MAC). The CMS-hosted outpatient therapy article A56566, revised April 1, 2026, identifies low-level/cold laser therapy as non-covered within that article's scope. Its discussion includes S8948, 97039, 0552T and 97037. Confirm which policy applies to the actual service and jurisdiction.1
Commercial payer policies also require an indication-specific review. Aetna's Clinical Policy Bulletin 0363, reviewed July 15, 2026, identifies several musculoskeletal applications of cold and high-power laser therapy as experimental, investigational or unproven. Check the full policy and the member's benefits rather than assuming one plan's decision applies to another.2
Distinguish procedure codes from diagnosis codes
97039 is a CPT procedure code for an unlisted modality. It is not an ICD-10-CM diagnosis code. The references to 0552T and 97037 in the CMS article are specific to its low-level laser discussion. Do not treat them as universal billing instructions for every laser device, indication or service. Verify the current code description and payer requirements with a qualified coding professional.1
Address patient responsibility before treatment
If a service may not be covered, clarify the applicable notice and financial-responsibility requirements before offering a cash-pay option. CMS explains that an Advance Beneficiary Notice of Noncoverage can transfer potential liability to an Original Medicare beneficiary in certain circumstances. Use the current CMS instructions and the responsible contractor's guidance to determine what is required for the specific situation.3
Keep the clinical decision and the payment discussion clear. This article does not establish a patient's coverage, select a billing code or predict treatment results, visit counts, patient savings or practice revenue. For equipment information, explore Chattanooga Rehab's laser therapy systems and discuss the device documentation with a representative.
References
1. Centers for Medicare & Medicaid Services. Billing and Coding: Outpatient Physical and Occupational Therapy Services (A56566). Revision effective April 1, 2026. See the contractor jurisdictions and the CPT 97039/low-level laser discussion. Accessed October 16, 2026.
2. Aetna. Cold Laser and High-Power Laser Therapies. Clinical Policy Bulletin 0363. Reviewed July 15, 2026. See Policy and Applicable Codes. Accessed October 16, 2026.
3. Centers for Medicare & Medicaid Services. Advance Beneficiary Notice of Noncoverage (FFS ABN). Updated July 17, 2026. Accessed October 16, 2026.
Individual results may vary. Neither DJO Global, Inc. nor any of its subsidiaries dispense medical advice. The contents of this website do not constitute medical, legal, or any other type of professional advice. Information related to various health, medical, and fitness conditions and their treatment is not meant to be a substitute for the advice provided by a physician or other medical professional. You should not use the information contained herein for diagnosing a health or fitness problem or disease. Rather, please consult your healthcare professional for information on the courses of treatment, if any, which may be appropriate for you.