CPT code 97116: Gait training, each 15 minutes, one-on-one2026 Medicare rate & RVUs in Washington, DC area

Timed one-on-one therapy to improve walking, stair negotiation, or assistive device use, reported in units supported by direct treatment time.

CMS RVU26DEffective Oct 1, 2026One payment locality5M Medicare services in 2024

In Washington, DC area, Medicare pays $32.35 for 97116 in the office.

$32.35Office (non-facility)
Not available in this settingHospital or facility
+11.3%vs the national office rate ($29.06)

Check a contract rate as a % of Medicare · 97116 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 97116 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 97116 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 97116 covers

Gait training is skilled, one-on-one instruction to improve a patient’s walking pattern, safety, and endurance. Typical patients include those recovering from stroke, hip or knee replacement, lower extremity fracture, Parkinson disease, or fall-related deconditioning. The therapist analyzes gait deviations and trains weight shifting, step length, cadence, stair climbing, curbs, and use of walkers, canes, or crutches. Physical therapists and physical therapist assistants commonly provide it in outpatient clinics and private practices, with use in skilled nursing and other Part B settings.

Report units based on direct one-on-one gait-training minutes; Medicare uses the combined minutes of timed therapy services that day to determine the total billable units under its 8-minute rule. Documentation should record treatment minutes, gait deficits addressed, cues or assistance levels, devices used, and progress toward the plan of care. Report the appropriate therapy discipline modifier, such as GP for a physical therapy plan. The professional component modifier is not used for this therapy service. Medicare’s therapy multiple procedure payment reduction reduces the practice expense portion for the second and later therapy units furnished the same day.

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.

Billing guides for 97116: Physical therapy CPT codes

How Washington, DC area compares for 97116

Across 109 of 109 payment localities, the office rate for 97116 runs from $26.97 in Arkansas to $37.31 in Alaska. Washington, DC area pays $32.35. The RVUs are the same everywhere; the geographic indexes change the dollars.

97116 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$32.35
  2. Los Angeles, CA · California$32.07−$0.28
  3. Miami, FL · Florida$30.13−$2.22
  4. Chicago, IL · Illinois$29.67−$2.68
  5. Manhattan, NY · New York$32.43+$0.08
  6. Alaska · Alaska$37.31+$4.96
  7. Alabama · Alabama$27.20−$5.15

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

97116 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$26.97—
ArizonaArizona$28.59—
Bakersfield, CACalifornia$30.53—
Chico, CACalifornia$30.47—
El Centro, CACalifornia$30.48—
Fresno, CACalifornia$30.47—
Hanford, CACalifornia$30.47—
Madera, CACalifornia$30.47—

97116 rates by state

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

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Local rates. Clear comparisons.

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

$26.97

$37.31

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

View every state and territory as a table
97116 office rate range by state
State / territoryOffice rate rangeLocalities
AK$37.311
AL$27.201
AR$26.971
AZ$28.591
CA$30.47–$36.6129
CO$30.041
CT$30.481
DC$32.351
DE$28.941
FL$28.62–$30.133
GA$27.64–$29.392
GU$30.791
HI$30.791
IA$27.691
ID$27.791
IL$28.06–$29.794
IN$27.891
KS$27.581
KY$27.511
LA$27.47–$28.302
MA$29.96–$32.292
MD$29.35–$32.353
ME$27.84–$28.812
MI$27.91–$28.812
MN$29.221
MO$27.16–$28.403
MS$27.071
MT$29.061
NC$28.021
ND$28.861
NE$27.801
NH$29.581
NJ$30.95–$32.222
NM$27.991
NV$29.021
NY$28.27–$32.905
OH$27.871
OK$27.521
OR$28.90–$30.732
PA$27.92–$29.962
PR$29.201
RI$29.761
SC$27.971
SD$28.841
TN$27.661
TX$27.80–$29.858
UT$28.201
VA$28.73–$32.352
VI$29.201
VT$28.761
WA$29.90–$32.862
WI$28.251
WV$27.411
WY$28.971

See 97116 in every payment locality

How the 97116 rate is calculated

Each of 97116’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 · 97116

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.45

0.45 RVUs× 1.000 GPCI

Practice expense0.41

0.41 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.8700

Conversion factor

$33.4009

Medicare rate

$29.06

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,862

Code
97116
Physician work
0.45
Practice expense
0.41
Malpractice
0.01

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 97116 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work0.45× 1.0540.4743
Practice expense0.41× 1.1780.4830
Malpractice0.01× 1.1130.0111
Total RVUs0.9684
Conversion factor× 33.4009

Office rate, Washington, DC area$32.35

Office: (0.45 × 1.054 + 0.41 × 1.178 + 0.01 × 1.113) × $33.4009 = $32.35

Open 97116 in the RVU calculator

Payment rules and modifiers for 97116

The CMS indicators that decide how 97116 is paid alongside other services.

CMS payment indicators · 97116

Gait training, each 15 minutes, one-on-one

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

97116 without CQ · national office

$29.06

Gait training, each 15 minutes, one-on-one

97116-CQ · Allowed amount unchanged

$29.06

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 97116 has changed in Washington, DC area

97116 · Office / nonfacility

$32.35

Effective 2026-10-01

The base rate is $0.01 higher than on 2025-10-01, moving from $32.34 to $32.35 (0.0%).

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

    $32.34changed to$32.35

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.43 changed to 0.41
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $32.89changed to$32.34

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.42 changed to 0.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $32.35changed to$32.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $33.80changed to$32.35

    • Conversion factor 33.8872 changed to 32.7442
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168
  5. January 1, 2023

    RVU23A

    $34.42changed to$33.80

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.40 changed to 0.42
    • Malpractice RVU 0.02 changed to 0.01
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $34.70changed to$34.42

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $35.14changed to$34.70

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.39 changed to 0.40
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $34.79changed to$35.14

    • Conversion factor 36.0391 changed to 36.0896
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $34.75changed to$34.79

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $32.37changed to$34.75

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 0.40 changed to 0.45
    • Malpractice RVU 0.01 changed to 0.02
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $32.34changed to$32.37

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $32.45changed to$32.34

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $32.29changed to$32.45

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $32.27changed to$32.29

    • Conversion factor 35.8228 changed to 35.7547
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $31.78changed to$32.27

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.42 changed to 0.39
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $31.78

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$32.35Not available in this settingRVU26D
2026-07-01$32.35Not available in this settingRVU26C
2026-04-01$32.35Not available in this settingRVU26B
2026-01-01$32.35Not available in this settingRVU26A
2025-10-01$32.34Not available in this settingRVU25D
2025-07-01$32.34Not available in this settingRVU25C
2025-04-01$32.34Not available in this settingRVU25B
2025-01-01$32.34Not available in this settingRVU25A
2024-10-01$32.89Not available in this settingRVU24D
2024-07-01$32.89Not available in this settingRVU24C
2024-04-01$32.89Not available in this settingRVU24B
2024-03-09$32.89Not available in this settingRVU24AR
2024-01-01$32.35Not available in this settingRVU24A
2023-10-01$33.80Not available in this settingRVU23D
2023-07-01$33.80Not available in this settingRVU23C
2023-04-01$33.80Not available in this settingRVU23B
2023-01-01$33.80Not available in this settingRVU23A
2022-10-01$34.42Not available in this settingRVU22D
2022-07-01$34.42Not available in this settingRVU22C
2022-04-01$34.42Not available in this settingRVU22B
2022-01-01$34.42Not available in this settingRVU22A
2021-10-01$34.70Not available in this settingRVU21D
2021-07-01$34.70Not available in this settingRVU21C
2021-04-01$34.70Not available in this settingRVU21B
2021-01-01$34.70Not available in this settingRVU21A
2020-10-01$35.14Not available in this settingRVU20D
2020-07-01$35.14Not available in this settingRVU20C
2020-04-01$35.14Not available in this settingRVU20B
2020-01-01$35.14Not available in this settingRVU20A
2019-10-01$34.79Not available in this settingRVU19D
2019-07-01$34.79Not available in this settingRVU19C
2019-04-01$34.79Not available in this settingRVU19B
2019-01-01$34.79Not available in this settingRVU19A
2018-10-01$34.75Not available in this settingRVU18D
2018-07-01$34.75Not available in this settingRVU18C
2018-04-01$34.75Not available in this settingRVU18B
2018-01-01$34.75Not available in this settingRVU18AR1
2017-10-01$32.37Not available in this settingRVU17D
2017-07-01$32.37Not available in this settingRVU17C
2017-04-01$32.37Not available in this settingRVU17B
2017-01-01$32.37Not available in this settingRVU17A
2016-10-01$32.34Not available in this settingRVU16D
2016-07-01$32.34Not available in this settingRVU16C
2016-04-01$32.34Not available in this settingRVU16B
2016-01-01$32.34Not available in this settingRVU16A
2015-10-01$32.45Not available in this settingRVU15D
2015-07-01$32.45Not available in this settingRVU15C
2015-04-01$32.29Not available in this settingRVU15B
2015-01-01$32.29Not available in this settingRVU15A
2014-10-01$32.27Not available in this settingRVU14D
2014-07-01$32.27Not available in this settingRVU14C
2014-04-01$32.27Not available in this settingRVU14B
2014-01-01$32.27Not available in this settingRVU14A
2013-10-01$31.78Not available in this settingRVU13D
2013-07-01$31.78Not available in this settingRVU13C
2013-04-01$31.78Not available in this settingRVU13B
2013-01-01$31.78Not available in this settingRVU13AR

Price 97116 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

97116 billing questions

How many units of gait training can be billed for a session?

Medicare combines minutes from timed therapy services to determine total units, then assigns units to services supported by their direct one-on-one minutes. Eight minutes of gait training alone supports one unit; seven minutes alone does not.

When should gait training be reported instead of neuromuscular reeducation?

Use gait training when treatment directly addresses walking, stairs, or device use during ambulation. Choose neuromuscular reeducation when the treatment primarily addresses balance, coordination, proprioception, or postural control, even if performed standing.

Is initial training to use a lower limb prosthesis reported as gait training?

Initial training centered on using a lower limb prosthesis is generally reported with the prosthetic training code. Gait training fits ambulation work not centered on initial prosthetic use.

Can gait training be billed on the same day as a physical therapy evaluation?

Yes, when distinct gait treatment is provided in addition to the evaluation and its treatment time is documented separately. Minutes spent assessing gait during the evaluation cannot also be counted as treatment.

Which modifiers are commonly appended?

Use the therapy discipline modifier, usually GP for a physical therapy plan of care. Append CQ when physical therapist assistant participation meets the applicable threshold.

Does the therapy multiple procedure payment reduction affect gait training units?

Yes. When more than one therapy unit is furnished on the same day, the practice expense portion is reduced for the second and later units.

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 97116PPRRVU2026_Oct_nonQPP.csv, line 12,862 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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