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Shockwave therapy for musculoskeletal conditions is usually reported with CPT 0101T, a Category III code, and most major insurers do not cover it. UnitedHealthcare's commercial policy effective October 1, 2026 calls ESWT unproven and not medically necessary for any musculoskeletal or soft tissue indication. A Blue Cross Blue Shield plan policy effective September 1, 2026 calls it investigational for musculoskeletal conditions, including plantar fasciitis. That is why most chiropractic and physical therapy practices offer shockwave as a cash-pay service.
This guide is general information, not billing or legal advice. Codes are updated every year and payer policies vary, so confirm with each payer and your billing professional before you submit a claim.
The CPT codes for shockwave therapy
These are the codes listed in current payer policies. The descriptions are summaries; check the current CPT code set for the official wording.
| Code | What it describes | Category |
|---|---|---|
| 0101T | Shock wave therapy of the musculoskeletal system, not otherwise specified | Category III (emerging technology) |
| 0102T | Shock wave therapy of the lateral humeral epicondyle, performed by a physician under anesthesia other than local | Category III |
| 28890 | High-energy shock wave therapy of the plantar fascia, performed by a physician or qualified professional under anesthesia other than local, with ultrasound guidance | Category I |
| 0512T, 0513T | Shock wave therapy for wound healing: first wound and each additional wound | Category III |
For in-office radial shockwave on a musculoskeletal complaint, 0101T is the code most payer policies list. Codes 0102T and 28890 describe high-energy procedures done under anesthesia, which is not how radial shockwave is delivered in a clinic.
What Category III codes mean for payment
Category III codes track emerging technologies and services. Having a code does not mean a payer covers the service, and many payers deny Category III codes as experimental or investigational. Their main use is to report accurately what you did.
Do not report shockwave under a code for a different service, such as a manual therapy or modality code, to obtain payment. Describe the service you actually provided.
What insurers say in 2026
| Payer policy | Effective | Position on musculoskeletal ESWT |
|---|---|---|
| UnitedHealthcare Commercial, policy 2026T0269MM | October 1, 2026 | Unproven and not medically necessary for any musculoskeletal or soft tissue indication, including radial wave |
| Premera Blue Cross, policy 2.01.40 (BCBSA reference policy) | September 1, 2026 | Investigational for musculoskeletal conditions, including plantar fasciitis, tendinopathies and lateral epicondylitis |
| Medicare | — | No national coverage determination; check your Medicare Administrative Contractor |
Other payers and individual plans may differ. Check each payer's current medical policy, and get a written benefits verification before treating a patient who expects insurance to pay.
Medicare and chiropractors
Medicare covers chiropractic services only for manual manipulation of the spine to correct a subluxation. Other therapeutic services furnished by a chiropractor, including shockwave, are not covered. Ask your billing professional how to document patient notice and financial responsibility for non-covered services.
How practices offer shockwave as a cash service
- Publish a session price and a package price, and give patients both in writing before treatment.
- Have patients sign a financial responsibility form stating the service is self-pay.
- If a patient asks, provide an itemized receipt with the code and diagnosis so they can submit it to their plan themselves, without promising reimbursement.
- Track sessions per week and payback against the cost of the machine.
Session prices vary by market. SoftWave TRT's provider materials cite $150 to $250 per session; our own payback examples use a more conservative $100 average. Use your local market price.
How fast a machine pays for itself
With a cash price per session, payback depends on two numbers: what you charge and how many sessions you deliver. At $100 per session, the Workhorse Mini at $3,949 takes about 40 sessions to cover its purchase price, the Workhorse Pro at $10,349 about 104, and the Workhorse XL at $13,349 about 134. Your costs for staff time, supplies and financing will add to those numbers.
- Run your own numbers in the ROI calculator
- Compare Workhorse machines and prices
- How to market shockwave therapy to your patients
Sources
Policies checked November 12, 2026. Payer policies are revised regularly; read the current version before relying on it.
See the machines
Compare the Workhorse lineup or run your numbers in the ROI calculator.