CPT code 97026: Infrared therapy2026 Medicare rate & RVUs in Connecticut

Reports application of infrared heat to a selected body area when the service is medically necessary and meets Medicare's limited coverage circumstances.

CMS RVU26DEffective Oct 1, 2026One payment locality30.7K Medicare services in 2024

In Connecticut, Medicare pays $7.12 for 97026 in the office.

$7.12Office (non-facility)
Not available in this settingHospital or facility
+6.6%vs the national office rate ($6.68)

Check a contract rate as a % of Medicare · 97026 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 97026 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 97026 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 97026 covers

Code 97026 represents therapeutic application of infrared heat, typically from an infrared lamp, to one or more body areas. Physical and occupational therapists may use it for localized pain or stiffness, including as a preparatory modality before movement or other skilled treatment. It is an untimed modality used in outpatient rehabilitation and clinician office settings.

Report the service only when infrared treatment is medically necessary and the case falls within Medicare's restricted coverage circumstances; a therapy diagnosis alone does not establish coverage. Document the treated area, clinical rationale, modality provided, and its relationship to the therapy plan. A professional-component modifier does not apply. CMS reduces practice expense for the second and later therapy units furnished on the same day. Because 97026 is untimed, do not count 15-minute increments.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Connecticut compares for 97026

Across 109 of 109 payment localities, the office rate for 97026 runs from $5.91 in Arkansas to $8.66 in San Benito County, CA. Connecticut pays $7.12. The RVUs are the same everywhere; the geographic indexes change the dollars.

97026 in Connecticut vs other payment areas
  1. Connecticut · this page$7.12
  2. Los Angeles, CA · California$7.44+$0.32
  3. Washington, DC area · District of Columbia$7.60+$0.48
  4. Miami, FL · Florida$7.37+$0.25
  5. Chicago, IL · Illinois$7.15+$0.03
  6. Manhattan, NY · New York$7.71+$0.59
  7. Alaska · Alaska$7.81+$0.69

Other areas in Connecticut first, then benchmark localities. Bars start at $0.

Every other payment area

97026 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$5.99—
ArkansasArkansas$5.91—
ArizonaArizona$6.50—
Bakersfield, CACalifornia$7.00—
Chico, CACalifornia$6.98—
El Centro, CACalifornia$6.98—
Fresno, CACalifornia$6.98—
Hanford, CACalifornia$6.98—

97026 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$5.91

$7.82

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
97026 office rate range by state
State / territoryOffice rate rangeLocalities
AK$7.811
AL$5.991
AR$5.911
AZ$6.501
CA$6.98–$8.6629
CO$6.911
CT$7.121
DC$7.601
DE$6.601
FL$6.66–$7.373
GA$6.28–$6.822
GU$7.131
HI$7.131
IA$6.111
ID$6.161
IL$6.49–$7.154
IN$6.191
KS$6.101
KY$6.171
LA$6.17–$6.472
MA$6.87–$7.572
MD$6.72–$7.603
ME$6.21–$6.522
MI$6.35–$6.762
MN$6.571
MO$6.07–$6.473
MS$5.991
MT$6.681
NC$6.271
ND$6.481
NE$6.141
NH$6.821
NJ$7.19–$7.522
NM$6.391
NV$6.631
NY$6.36–$7.925
OH$6.311
OK$6.141
OR$6.56–$7.112
PA$6.31–$6.962
PR$6.721
RI$6.831
SC$6.301
SD$6.461
TN$6.131
TX$6.27–$6.908
UT$6.391
VA$6.51–$7.602
VI$6.721
VT$6.471
WA$6.86–$7.702
WI$6.271
WV$6.261
WY$6.591

See 97026 in every payment locality

How the 97026 rate is calculated

Each of 97026’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 97026

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.06

0.06 RVUs× 1.000 GPCI

Practice expense0.13

0.13 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.2000

Conversion factor

$33.4009

Medicare rate

$6.68

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,850

Code
97026
Physician work
0.06
Practice expense
0.13
Malpractice
0.01

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 97026 in Connecticut
ComponentRVULocality factorAdjusted
Physician work0.06× 1.0200.0612
Practice expense0.13× 1.0770.1400
Malpractice0.01× 1.2100.0121
Total RVUs0.2133
Conversion factor× 33.4009

Office rate, Connecticut$7.12

Office: (0.06 × 1.02 + 0.13 × 1.077 + 0.01 × 1.21) × $33.4009 = $7.12

Open 97026 in the RVU calculator

Payment rules and modifiers for 97026

The CMS indicators that decide how 97026 is paid alongside other services.

CMS payment indicators · 97026

Infrared therapy

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures5Therapy reduction: practice expense of the second and later units is reduced.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

97026 without CQ · national office

$6.68

Infrared therapy

97026-CQ · Allowed amount unchanged

$6.68

Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.

How 97026 has changed in Connecticut

97026 · Office / nonfacility

$7.12

Effective 2026-10-01

The base rate is $0.19 lower than on 2025-10-01, moving from $7.31 to $7.12 (2.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $7.31changed to$7.12

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.14 changed to 0.13
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $7.16changed to$7.31

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.13 changed to 0.14

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $7.05changed to$7.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $7.31changed to$7.05

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207
  5. January 1, 2023

    RVU23A

    $7.10changed to$7.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.12 changed to 0.13
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $7.16changed to$7.10

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $7.04changed to$7.16

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.11 changed to 0.12
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $7.07changed to$7.04

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $7.06changed to$7.07

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $6.66changed to$7.06

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.10 changed to 0.11
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $6.65changed to$6.66

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $6.68changed to$6.65

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $6.65changed to$6.68

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $6.64changed to$6.65

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $6.66changed to$6.64

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.11 changed to 0.10
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $6.66

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$7.12Not available in this settingRVU26D
2026-07-01$7.12Not available in this settingRVU26C
2026-04-01$7.12Not available in this settingRVU26B
2026-01-01$7.12Not available in this settingRVU26A
2025-10-01$7.31Not available in this settingRVU25D
2025-07-01$7.31Not available in this settingRVU25C
2025-04-01$7.31Not available in this settingRVU25B
2025-01-01$7.31Not available in this settingRVU25A
2024-10-01$7.16Not available in this settingRVU24D
2024-07-01$7.16Not available in this settingRVU24C
2024-04-01$7.16Not available in this settingRVU24B
2024-03-09$7.16Not available in this settingRVU24AR
2024-01-01$7.05Not available in this settingRVU24A
2023-10-01$7.31Not available in this settingRVU23D
2023-07-01$7.31Not available in this settingRVU23C
2023-04-01$7.31Not available in this settingRVU23B
2023-01-01$7.31Not available in this settingRVU23A
2022-10-01$7.10Not available in this settingRVU22D
2022-07-01$7.10Not available in this settingRVU22C
2022-04-01$7.10Not available in this settingRVU22B
2022-01-01$7.10Not available in this settingRVU22A
2021-10-01$7.16Not available in this settingRVU21D
2021-07-01$7.16Not available in this settingRVU21C
2021-04-01$7.16Not available in this settingRVU21B
2021-01-01$7.16Not available in this settingRVU21A
2020-10-01$7.04Not available in this settingRVU20D
2020-07-01$7.04Not available in this settingRVU20C
2020-04-01$7.04Not available in this settingRVU20B
2020-01-01$7.04Not available in this settingRVU20A
2019-10-01$7.07Not available in this settingRVU19D
2019-07-01$7.07Not available in this settingRVU19C
2019-04-01$7.07Not available in this settingRVU19B
2019-01-01$7.07Not available in this settingRVU19A
2018-10-01$7.06Not available in this settingRVU18D
2018-07-01$7.06Not available in this settingRVU18C
2018-04-01$7.06Not available in this settingRVU18B
2018-01-01$7.06Not available in this settingRVU18AR1
2017-10-01$6.66Not available in this settingRVU17D
2017-07-01$6.66Not available in this settingRVU17C
2017-04-01$6.66Not available in this settingRVU17B
2017-01-01$6.66Not available in this settingRVU17A
2016-10-01$6.65Not available in this settingRVU16D
2016-07-01$6.65Not available in this settingRVU16C
2016-04-01$6.65Not available in this settingRVU16B
2016-01-01$6.65Not available in this settingRVU16A
2015-10-01$6.68Not available in this settingRVU15D
2015-07-01$6.68Not available in this settingRVU15C
2015-04-01$6.65Not available in this settingRVU15B
2015-01-01$6.65Not available in this settingRVU15A
2014-10-01$6.64Not available in this settingRVU14D
2014-07-01$6.64Not available in this settingRVU14C
2014-04-01$6.64Not available in this settingRVU14B
2014-01-01$6.64Not available in this settingRVU14A
2013-10-01$6.66Not available in this settingRVU13D
2013-07-01$6.66Not available in this settingRVU13C
2013-04-01$6.66Not available in this settingRVU13B
2013-01-01$6.66Not available in this settingRVU13AR

Price 97026 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

97026 billing questions

How does 97026 differ from diathermy?

97026 reports infrared heat, commonly delivered by an infrared lamp. Diathermy is a different modality and is reported with 97024.

Is 97026 a timed service?

No. It is an untimed modality, so units are not counted in 15-minute increments.

Can modifier 26 be appended?

No. CMS identifies 97026 as a therapy service for which the professional-component modifier does not apply.

What documentation supports reporting 97026?

Record the body area treated, the clinical reason for infrared therapy, the modality provided, and how it relates to the therapy plan. Medicare payment is restricted to specific circumstances.

Can 97026 be reported with exercise or another modality?

97026 identifies the infrared application itself, not exercise or another treatment. Report another service only when it was separately furnished and its own reporting requirements are met.

How does the therapy multiple procedure reduction affect 97026?

CMS reduces practice expense for the second and later therapy units furnished on the same day. The reduction applies to practice expense.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 97026PPRRVU2026_Oct_nonQPP.csv, line 12,850 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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