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Physical, occupational & speech therapy

97116 - RVUs & Medicare payment (2026)

Gait training, each 15 minutes.

Component Non-facility Facility
Work RVU 0.45 0.45
Practice expense RVU 0.41 0.41
Malpractice RVU 0.01 0.01
Total RVUs 0.87 0.87
National payment (CF $33.4009) $29.06 $29.06
Qualifying APM payment (CF $33.5675) $29.20 $29.20

How 97116 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 97116 ranges from $26.97 in Arkansas (AR) to $37.31 in Alaska (AK); calculate 97116 for your locality.

Alaska (AK) $37.31 San Jose-Sunnyvale-Santa Clara (CA) $36.61 San Jose-Sunnyvale-Santa Clara (CA) $36.56 San Francisco-Oakland-Berkeley (CA) $35.92 San Francisco-Oakland-Berkeley (CA) $35.91 Napa (CA) $34.20 Vallejo (CA) $34.18 NYC Suburbs/Long Island (NY) $32.90 National average $29.06 … 97 more localities between … Alabama (AL) $27.20 Rest Of Missouri (MO) $27.16 Mississippi (MS) $27.07 Arkansas (AR) $26.97
Non-facility payment for 97116 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - physical, occupational & speech therapy

  • 97161 · physical therapy evaluation, low complexity
  • 97162 · physical therapy evaluation, moderate complexity
  • 97163 · physical therapy evaluation, high complexity
  • 97164 · physical therapy re-evaluation
  • 97165 · occupational therapy evaluation, low complexity
  • 97166 · occupational therapy evaluation, moderate complexity
  • 97167 · occupational therapy evaluation, high complexity
  • 97110 · therapeutic exercise, each 15 minutes
  • 97112 · neuromuscular re-education, each 15 minutes
  • 97140 · manual therapy, each 15 minutes
  • 97530 · therapeutic activities, each 15 minutes
  • 97535 · self-care and home management training, each 15 minutes
  • 92507 · speech, language, voice treatment, individual
  • 92523 · evaluation of speech sound production and language
  • 92526 · treatment of swallowing or oral feeding function
  • 98940 · chiropractic manipulation, 1-2 spinal regions
  • 98941 · chiropractic manipulation, 3-4 spinal regions
  • 98942 · chiropractic manipulation, 5 spinal regions
  • 97810 · acupuncture without electrical stimulation, initial 15 minutes
  • 97811 · acupuncture without electrical stimulation, each additional 15 minutes
  • 97813 · acupuncture with electrical stimulation, initial 15 minutes
  • 97814 · acupuncture with electrical stimulation, each additional 15 minutes

Frequently asked questions

How much does Medicare pay for 97116 in 2026?
The national non-facility payment is $29.06 and the facility payment is $29.06, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.
What is the work RVU for 97116?
The 2026 work RVU for 97116 is 0.45. Total RVUs are 0.87 in the non-facility setting and 0.87 in the facility setting.
Why are the facility and non-facility amounts different?
Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.