Which CPT Codes Do Naturopaths Commonly Use for Insurance Billing?

Naturopathic physicians use the same Current Procedural Terminology (CPT) codes as conventional medical doctors. However, insurance reimbursement for naturopathic care often becomes confusing for patients and even providers. This is due to coverage limitations, state laws, and payer-specific policies, not to incorrect coding.

Understanding which CPT codes naturopaths commonly use, how insurers evaluate claims, and what documentation is required can significantly reduce denials, unexpected bills, and reimbursement delays.

What Are CPT Codes and Why Naturopaths Need Them

CPT stands for Current Procedural Terminology. These codes were created by the American Medical Association (AMA) to standardize the reporting of medical services and procedures nationwide. CPT codes make up HCPCS Level I and are essential for billing both public and private insurers. CPT codes are updated annually to reflect current medical practice.

Naturopaths use CPT codes to report services such as exams, tests, counseling, and procedures. Insurers universally require these codes for claims processing. Without proper coding, reimbursements decline, and denials increase.

  • Level I CPT codes: 5-digit numeric codes for physician services
  • Level II HCPCS codes: alphanumeric codes for supplies and non‑physician services

Modifiers may be attached to CPT codes to indicate distinct procedural circumstances, such as separate services provided on the same day.

Three CPT Code Categories

CPT codes are separated into three categories based on purpose and clinical usage:

  1. Category I Codes: Five-digit numeric codes representing standard, FDA‑approved procedures and services, including Evaluation & Management (E/M), lab tests, and counseling.
     2. Category II Codes: Four digits plus an “F” used for quality tracking and performance measurement (optional reporting).
     3. Category III Codes: Four digits plus a “T” for emerging technologies and procedures that lack broad FDA approval or widespread clinical use; these codes are temporary.

These categories help payers and providers distinguish routine, tracked, and novel services when submitting claims. 

Core Principles of Naturopathic Medicine Billing

Naturopathic doctors follow a therapeutic order. Step 1 removes obstacles to health. Step 7 uses surgery only as a last resort. This guides CPT code selection.

Key Naturopathic Principles:

  • Identify disease causes (genetics, lifestyle, toxins)
  • Restore a healthy diet and lifestyle first
  • Stimulate the body’s innate healing
  • Use natural substances before synthetics

These principles map to billable services. Counseling becomes 99401. Lifestyle changes justify 97802 nutrition therapy.

Evaluation and Management: Foundation of Naturopathic Billing

Evaluation & Management (E/M) codes (99201–99215) are the backbone of outpatient billing, including naturopaths. These codes represent office visits and vary by the complexity of the visit or total time spent on the date of the encounter.

Important CPT Coding Update

As of January 1, 2021, E/M code selection for office and outpatient visits is based on either Medical Decision Making (MDM) or total time spent on the day of the encounter, and documentation no longer requires rigid history/physical exam components. This simplifies coding and aligns payment with clinical effort. 

New Patient E/M Codes:

  • 99201: Minimal decision-making (discontinued 2021)
  • 99202: Low complexity (15 min)
  • 99203: Moderate (30 min) – most common
  • 99204: High (45 min)
  • 99205: Very high (60 min)

Established Patient Codes:

  • 99211: Nurse visits only
  • 99212: Minimal (10 min)
  • 99213: Low-moderate (20 min) – most used
  • 99214: Moderate-high (40 min)
  • 99215: High (55 min)

Document time spent on our medical decision-making. A 30-minute constitutional hydrotherapy consultation is billed as 99203.

Preventive Medicine Services CPT Codes

Prevention defines naturopathy. Bill’s annual exams and counseling separately.

Initial Preventive Codes (99381-99387):

  • 99381: Infant (under 1 year)
  • 99385: 18-39 years – common for adults
  • 99387: 65+ years

Periodic Preventive (99391-99397): 

Same age ranges for established patients.

Counseling Codes:

  • 99401: 15 minutes individual
  • 99402: 30 minutes
  • 99411: Group (16+ people)

Medicare covers limited preventive services. Private payers reimburse better in licensed states.

Common Naturopathic Lab Testing CPT Codes

Labs confirm naturopathic diagnoses. Use standard codes for insurance acceptance.

Most Frequent Lab Codes:

  • 81000-81003: Urinalysis
  • 82270: Occult blood (colorectal screening)
  • 83036: HbA1c (diabetes monitoring)
  • 85014: Hematocrit
  • 86308: Mononucleosis test
  • 87880: Rapid strep test

Diagnostic Tests:

  • 93000: ECG with interpretation
  • 94010: Spirometry
  • 66580: TB skin test

CLIA-certified labs ensure reimbursement. Document medical necessity clearly.

Physical Medicine and Therapy CPT Codes

Hands-on therapies boost naturopathic revenue. Time-based billing maximizes payments.

Therapy Codes:

  • 96372: Therapeutic injection
  • 69210: Cerumen removal
  • 12001-12021: Wound repair

Vaccines and Injections:

  • J0171: Epinephrine
  • J1200: Diphenhydramine
  • J3150: Testosterone injection

State scope-of-practice limits apply to some codes. Washington NDs bill most therapies fully.

Nutrition Counseling and Lifestyle Medicine Codes

Dietary counseling generates steady revenue. Medical nutrition therapy codes reimburse well.

Nutrition Codes:

  • 97802: Initial 15-30 minutes
  • 97803: Re-evaluation 15 minutes
  • 97804: Each additional 15 minutes

Specialty Counseling:

  • 99406-99407: Smoking cessation
  • 99408-99409: Alcohol/drug screening

Link to ICD-10 codes like E66.9 (obesity) or Z71.3 (dietary counseling).

Women’s Health and Minor Procedures

Naturopaths perform many GYN procedures. Bill standard codes when trained.

GYN Codes:

  • 99385-99387: Initial Pap smear
  • 99395-99397: Periodic Pap smear
  • 58300: IUD insertion
  • 58301: IUD removal

Minor Procedures:

  • 36145: Venipuncture
  • 46600: Anoscopy
  • 87205: KOH prep for vaginal infection

Table: CPT Codes for Naturopathic Medicine

CPT Code(s) Description of Naturopathic Medicine Services
99391-99397 Comprehensive re-evaluation and management of an established patient
99211-99215 Re-evaluation and management of an established patient with minimal complaints
99381-99387 Comprehensive evaluation and management of a new patient
99201-99205 Evaluation, management, and straightforward decision-making for a new patient
66580 Skin antigen test for tuberculosis
87880 Strep test for Streptococcus group A infection
81000-81003 Urinalysis
82270 Occult blood test for colorectal neoplasm screening
81025 Pregnancy test
87205 Smear procedure for detecting vaginal infection
93000 ECG with interpretation and report
94010 Spirometry (diagnostic function lung test)
87220 Preparing tissue with KOH for microscopic examination
86308 Mononucleosis spot test
83036 HbA1C test
85014 Blood test for measuring hematocrit, or the volume of red blood cells
99381-99397 Annual physical assessment of the patient
99385-99387 Initial pap smear in a new patient
99395-99397 Periodic pap smear in an established new patient
36145 Venipuncture for drawing venous blood
96372 Injection for therapeutic, diagnostic, and preventive purposes
46600 Endoscopy of the anus
69210 Impacted cerumen removal
12001-12019 Repair of the superficial wounds
12020-12021 Treatment of the superficial wounds
99401-99404 Preventive medicine counseling of individual patients
99411-99412 Preventive medicine counseling of a group of patients
97802 Dietary counseling
99406-99407 Counseling for tobacco use cessation
99408-99409 Screening for alcohol and non-tobacco abuse
58300 Insertion of an intrauterine device
58301 Removal of an intrauterine device
J0171 Epinephrine administration
J1200 Diphenhydramine administration
J3150 Testosterone propionate injection

State Licensure Impact on CPT Code Reimbursement

Only 25 states license naturopathic doctors. Insurance coverage varies widely.

Full Insurance Parity (5 states):

  • Arizona, Connecticut, New Hampshire
  • Oregon, Vermont

Limited Coverage States: Washington, California, Maryland

No Coverage: Most states require cash-pay or superbill reimbursement.

Check state insurance departments. Licensed NDs collect 3x more insurance revenue.

Documentation Requirements for Naturopathic Claims

Payers deny 28% of naturopathic claims due to documentation gaps. Include these elements:

  • Chief complaint
  • History of present illness
  • Review of systems
  • Physical exam findings
  • Assessment and treatment plan
  • Time spent counseling
  • Medical necessity statement

Superbills help cash patients seek reimbursement. Electronic health records streamline compliance.

Common Billing Mistakes to Avoid

Denials cost naturopaths $18,000 yearly. Top errors include:

  • Unlisted codes instead of specific CPT
  • Missing -25 modifier for separate E/M
  • Wrong patient status (new vs established)
  • No medical necessity documentation
  • Incorrect ICD-10 linkage

Pre-verify insurance. Use certified coders for complex claims.

Let Our Experts Handle Your Naturopathic Billing

Mastering which CPT codes naturopaths commonly use for insurance billing transforms practice revenue. From E/M visits to nutrition counseling, precise coding secures payments. Strong documentation prevents denials and audit risks.

Ready to optimize naturopathic billing? Partner with West Virginia Medical Billing for expert CPT coding, claim submission, and denial management tailored for holistic providers.

Frequently Asked Questions

1. How do naturopaths bill for hydrotherapy treatments?

Hydrotherapy bills as 97140 manual therapy (15-min units). Document water temperature, duration, and therapeutic goals. Private payers reimburse $28-35 per unit in licensed states.​

2. Can NDs use telehealth CPT codes for consultations?

Yes, 99212-99215 with POS 10 (telehealth). Requires audio-video for Medicare patients post-PHE. Document informed consent and the platform used. 

3. What’s the correct code for B12 vitamin injections?

96372 (administration) + J3420 (cyanocobalamin). Bill with D51.0 anemia diagnosis. Reimburses $25-40 combined per injection. 

4. Do naturopaths bill for botanical medicine dispensing?

No separate code exists. Include in E/M visit or use 99050 supplies fee. Document herbs given and medical rationale. Compounding pharmacies bill separately.

5. How to code naturopathic homeopathy consultations?

Same E/M codes (99213/99203) as conventional visits. Document the selection process for the remedy and its potency. No specific homeopathy CPT code exists.