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

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 Tennessee, Medicare pays $27.66 for 97116 in the office.

$27.66Office (non-facility)
Not available in this settingHospital or facility
−4.8%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 Tennessee
  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 Tennessee 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. Tennessee pays $27.66. The RVUs are the same everywhere; the geographic indexes change the dollars.

97116 in Tennessee vs other payment areas
  1. Tennessee · this page$27.66
  2. Los Angeles, CA · California$32.07+$4.41
  3. Washington, DC area · District of Columbia$32.35+$4.69
  4. Miami, FL · Florida$30.13+$2.47
  5. Chicago, IL · Illinois$29.67+$2.01
  6. Manhattan, NY · New York$32.43+$4.77
  7. Alaska · Alaska$37.31+$9.65

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

Every other payment area

97116 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$27.20—
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—

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 Tennessee 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

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 97116 in Tennessee
ComponentRVULocality factorAdjusted
Physician work0.45× 1.0000.4500
Practice expense0.41× 0.9090.3727
Malpractice0.01× 0.5370.0054
Total RVUs0.8281
Conversion factor× 33.4009

Office rate, Tennessee$27.66

Office: (0.45 × 1 + 0.41 × 0.909 + 0.01 × 0.537) × $33.4009 = $27.66

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 Tennessee

97116 · Office / nonfacility

$27.66

Effective 2026-10-01

The base rate is $0.47 higher than on 2025-10-01, moving from $27.19 to $27.66 (1.7%).

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

    $27.19changed to$27.66

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.43 changed to 0.41
    • Practice expense GPCI 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $27.69changed to$27.19

    • 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

    $27.24changed to$27.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $28.15changed to$27.24

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544
  5. January 1, 2023

    RVU23A

    $28.26changed to$28.15

    • 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
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $28.50changed to$28.26

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $29.23changed to$28.50

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.39 changed to 0.40
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $29.26changed to$29.23

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $29.23changed to$29.26

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$29.23

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$27.66Not available in this settingRVU26D
2026-07-01$27.66Not available in this settingRVU26C
2026-04-01$27.66Not available in this settingRVU26B
2026-01-01$27.66Not available in this settingRVU26A
2025-10-01$27.19Not available in this settingRVU25D
2025-07-01$27.19Not available in this settingRVU25C
2025-04-01$27.19Not available in this settingRVU25B
2025-01-01$27.19Not available in this settingRVU25A
2024-10-01$27.69Not available in this settingRVU24D
2024-07-01$27.69Not available in this settingRVU24C
2024-04-01$27.69Not available in this settingRVU24B
2024-03-09$27.69Not available in this settingRVU24AR
2024-01-01$27.24Not available in this settingRVU24A
2023-10-01$28.15Not available in this settingRVU23D
2023-07-01$28.15Not available in this settingRVU23C
2023-04-01$28.15Not available in this settingRVU23B
2023-01-01$28.15Not available in this settingRVU23A
2022-10-01$28.26Not available in this settingRVU22D
2022-07-01$28.26Not available in this settingRVU22C
2022-04-01$28.26Not available in this settingRVU22B
2022-01-01$28.26Not available in this settingRVU22A
2021-10-01$28.50Not available in this settingRVU21D
2021-07-01$28.50Not available in this settingRVU21C
2021-04-01$28.50Not available in this settingRVU21B
2021-01-01$28.50Not available in this settingRVU21A
2020-10-01$29.23Not available in this settingRVU20D
2020-07-01$29.23Not available in this settingRVU20C
2020-04-01$29.23Not available in this settingRVU20B
2020-01-01$29.23Not available in this settingRVU20A
2019-10-01$29.26Not available in this settingRVU19D
2019-07-01$29.26Not available in this settingRVU19C
2019-04-01$29.26Not available in this settingRVU19B
2019-01-01$29.26Not available in this settingRVU19A
2018-10-01$29.23Not available in this settingRVU18D
2018-07-01$29.23Not available in this settingRVU18C
2018-04-01$29.23Not available in this settingRVU18B
2018-01-01Rate data unavailableNot available in this settingRVU18AR1
2017-10-01Rate data unavailableNot available in this settingRVU17D
2017-07-01Rate data unavailableNot available in this settingRVU17C
2017-04-01Rate data unavailableNot available in this settingRVU17B
2017-01-01Rate data unavailableNot available in this settingRVU17A
2016-10-01Rate data unavailableNot available in this settingRVU16D
2016-07-01Rate data unavailableNot available in this settingRVU16C
2016-04-01Rate data unavailableNot available in this settingRVU16B
2016-01-01Rate data unavailableNot available in this settingRVU16A
2015-10-01Rate data unavailableNot available in this settingRVU15D
2015-07-01Rate data unavailableNot available in this settingRVU15C
2015-04-01Rate data unavailableNot available in this settingRVU15B
2015-01-01Rate data unavailableNot available in this settingRVU15A
2014-10-01Rate data unavailableNot available in this settingRVU14D
2014-07-01Rate data unavailableNot available in this settingRVU14C
2014-04-01Rate data unavailableNot available in this settingRVU14B
2014-01-01Rate data unavailableNot available in this settingRVU14A
2013-10-01Rate data unavailableNot available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 97116 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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 TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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