NPI Portal NPI Lookup & Verification

Physical, occupational & speech therapy

97535 - RVUs & Medicare payment (2026)

Self-care and home management training, each 15 minutes.

Component Non-facility Facility
Work RVU 0.45 0.45
Practice expense RVU 0.51 0.51
Malpractice RVU 0.01 0.01
Total RVUs 0.97 0.97
National payment (CF $33.4009) $32.40 $32.40
Qualifying APM payment (CF $33.5675) $32.56 $32.56

How 97535 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 97535 ranges from $29.84 in Arkansas (AR) to $41.43 in San Jose-Sunnyvale-Santa Clara (CA); calculate 97535 for your locality.

San Jose-Sunnyvale-Santa Clara (CA) $41.43 San Jose-Sunnyvale-Santa Clara (CA) $41.38 Alaska (AK) $40.87 San Francisco-Oakland-Berkeley (CA) $40.63 San Francisco-Oakland-Berkeley (CA) $40.62 Napa (CA) $38.60 Vallejo (CA) $38.58 Seattle (WA) $36.96 National average $32.40 … 97 more localities between … Alabama (AL) $30.12 Rest Of Missouri (MO) $30.04 Mississippi (MS) $29.94 Arkansas (AR) $29.84
Non-facility payment for 97535 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
  • 97116 · gait training, each 15 minutes
  • 97140 · manual therapy, each 15 minutes
  • 97530 · therapeutic activities, 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 97535 in 2026?
The national non-facility payment is $32.40 and the facility payment is $32.40, 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 97535?
The 2026 work RVU for 97535 is 0.45. Total RVUs are 0.97 in the non-facility setting and 0.97 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.