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Official Description

Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Biofeedback training for the perineal muscles, specifically targeting the anorectal or urethral sphincter, is a therapeutic procedure designed to assist patients in managing conditions such as urinary retention, urinary incontinence, fecal incontinence, and constipation. This training utilizes advanced techniques, including electromyography (EMG) and/or manometry, to provide real-time feedback on muscle activity. During the procedure, a manometer probe equipped with multiple microsensors and a balloon, or a water-perfused probe with side holes, is inserted into the rectum. These devices are instrumental in visualizing or audibly displaying the activity of muscles in the abdomen, rectum, pelvic floor, and anal sphincter. They help identify dyssynergic muscle activity, which can hinder normal defecation. Through neuromuscular conditioning techniques, patients learn to enhance the coordination of their anorectal muscles. For bladder sphincter dyssynergia, the training involves exercises that focus on tensing and relaxing the pelvic muscles, alongside practicing relaxation techniques during voiding. Additionally, a biofeedback device that records urinary flow and EMG is employed, providing a visual display that alerts the patient to variations in pelvic floor and urethral sphincter tension. This comprehensive approach enables patients to effectively coordinate their pelvic floor muscles and improve control over the urethral sphincter. The CPT® Code 90912 is reported for the initial 15 minutes of one-on-one training using these biofeedback techniques, while CPT® Code 90913 is used for each subsequent 15-minute increment of training.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The biofeedback training procedure is indicated for various conditions affecting the pelvic floor and sphincter control. These include:

  • Urinary Retention - A condition where the patient is unable to empty the bladder completely, leading to discomfort and potential complications.
  • Urinary Incontinence - The involuntary loss of urine, which can significantly impact a patient's quality of life.
  • Fecal Incontinence - The inability to control bowel movements, resulting in unintentional leakage of stool.
  • Constipation - A common digestive issue characterized by infrequent or difficult bowel movements, often requiring intervention to improve muscle coordination.

2. Procedure

The biofeedback training procedure consists of several key steps that are essential for effective treatment. Each step is designed to facilitate patient understanding and engagement in their own care.

  • Initial Assessment - The healthcare professional conducts an initial assessment to determine the patient's specific needs and the underlying issues contributing to their condition. This assessment may include a review of medical history and symptoms.
  • Device Setup - The biofeedback device is prepared for use. This involves the insertion of a manometer probe into the rectum, which is equipped with multiple microsensors or a water-perfused probe. The setup is crucial for accurately measuring muscle activity.
  • Training Session - During the initial 15-minute training session, the patient engages in one-on-one contact with the healthcare professional. The professional guides the patient through exercises aimed at improving muscle coordination. The patient receives real-time feedback on their muscle activity through visual or auditory displays provided by the biofeedback device.
  • Neuromuscular Conditioning - The patient practices neuromuscular conditioning techniques, which may include exercises to tense and relax pelvic muscles. This step is vital for enhancing the coordination of the anorectal muscles and improving overall function.
  • Feedback and Adjustment - Throughout the session, the healthcare professional provides feedback based on the data displayed by the biofeedback device. Adjustments to the training techniques may be made to better suit the patient's progress and needs.

3. Post-Procedure

After the biofeedback training session, patients are typically advised on post-procedure care and follow-up. It is common for patients to experience some initial fatigue or muscle soreness due to the exercises performed. Patients may be encouraged to practice the techniques learned during the session at home to reinforce muscle coordination. Follow-up appointments may be scheduled to monitor progress and make any necessary adjustments to the training regimen. The healthcare professional will also discuss the importance of continued practice and may provide additional resources or exercises to support the patient's ongoing improvement.

Short Descr BFB TRAINING 1ST 15 MIN
Medium Descr BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT
Long Descr Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
Berenson-Eggers TOS (BETOS) none
MUE 1

This is a primary code that can be used with these additional add-on codes.

90913 Add-on Code MPFS Status: Active Code APC A Biofeedback training, perineal muscles, anorectal or urethral sphincter, including EMG and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (List separately in addition to code for primary procedure)
GP Services delivered under an outpatient physical therapy plan of care
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
KX Requirements specified in the medical policy have been met
CQ Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GO Services delivered under an outpatient occupational therapy plan of care
GA Waiver of liability statement issued as required by payer policy, individual case
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
24 Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service.
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
97 Rehabilitative services: when a service or procedure that may be either habilitative or rehabilitative in nature is provided for rehabilitative purposes, the physician or other qualified health care professional may add modifier 97 to the service or procedure code to indicate that the service or procedure provided was a rehabilitative service. rehabilitative services help an individual keep, get back, or improve skills and functioning for daily living that have been lost or impaired because the individual was sick, hurt, or disabled.
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CG Policy criteria applied
CO Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
CR Catastrophe/disaster related
GZ Item or service expected to be denied as not reasonable and necessary
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
UD Medicaid level of care 13, as defined by each state
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
Date
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2020-01-01 Added Code added.
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