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

In Vermont, Medicare pays $28.76 for 97116 in the office.

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.

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.

How Vermont 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. Vermont pays $28.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

97116 rates by state

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

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.

Payment rules and modifiers for 97116

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

What modifiers do to the payment

Codes related to 97116

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 97116 has changed in Vermont

Price 97116 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates