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CPT code 97535: Self-care training, ADL and home management, per 15 minutes2026 Medicare rate & RVUs

Direct, one-on-one training in daily living and home management skills, such as dressing or meal preparation, reported as a timed therapy service.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.9M Medicare services in 2024

Medicare pays $32.40 for 97535 nationally in the office. Local office rates run $29.84–$41.43.

Medicare rate · 97535

Self-care training, ADL and home management, per 15 minutes

Office or facility?

Work RVUs
0.45
Total RVUs
0.97
Global days
XXX

National rate · 2026

$32.40

Office setting, before claim adjustments.

See every locality for 97535 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 97535 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 97535 covers

This service involves direct, one-on-one instruction that helps a patient manage personal care and home tasks safely. Typical content includes training in dressing, bathing, toileting, grooming, feeding, kitchen safety, and meal preparation. Instruction may address compensatory techniques after a stroke or joint replacement, energy conservation, or use of adaptive equipment such as reachers, sock aids, and tub benches. Occupational therapists commonly provide this training; physical therapists may also provide it when appropriate to the treatment plan. Settings include private practices, outpatient therapy clinics, and hospital outpatient departments.

Report this timed code for documented patient-directed self-care or home management training. Record the tasks practiced, the patient's assistance needs, the instruction and cues provided, and direct treatment minutes. Medicare uses total timed therapy minutes to determine the day's allowable units; code-specific minutes support how those units are allocated. Identify the therapy plan of care with the appropriate discipline modifier. This therapy service has no professional component to report with modifier 26. Under the therapy multiple procedure payment reduction, practice expense is reduced for the second and later therapy units furnished on 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 97535: Physical therapy CPT codes

Where 97535 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$29.84 to $41.43

$29.84$35.63$41.43
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

97535 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$30.12Unavailable
Alaska$40.87Unavailable
Arizona$31.82Unavailable
Arkansas$29.84Unavailable
Atlanta, GA$32.78Unavailable
Austin, TX$33.38Unavailable
Bakersfield, CA$34.19Unavailable
Baltimore area, MD$33.96Unavailable
Beaumont, TX$30.84Unavailable
Brazoria, TX$32.29Unavailable

97535 rates by state

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

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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.

$29.84

$40.87

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

View every state and territory as a table
97535 office rate range by state
State / territoryOffice rate rangeLocalities
AK$40.871
AL$30.121
AR$29.841
AZ$31.821
CA$34.13–$41.4329
CO$33.601
CT$34.081
DC$36.281
DE$32.241
FL$31.82–$33.613
GA$30.62–$32.782
GU$34.591
HI$34.591
IA$30.751
ID$30.861
IL$31.10–$33.224
IN$30.981
KS$30.601
KY$30.481
LA$30.43–$31.442
MA$33.47–$36.282
MD$32.73–$36.283
ME$30.91–$32.122
MI$30.96–$32.032
MN$32.661
MO$30.04–$31.583
MS$29.941
MT$32.401
NC$31.141
ND$32.201
NE$30.881
NH$33.061
NJ$34.60–$36.092
NM$31.051
NV$32.361
NY$31.45–$36.875
OH$30.921
OK$30.501
OR$32.23–$34.442
PA$30.98–$33.432
PR$32.581
RI$33.211
SC$31.051
SD$32.181
TN$30.691
TX$30.84–$33.388
UT$31.341
VA$32.01–$36.282
VI$32.581
VT$32.061
WA$33.42–$36.962
WI$31.451
WV$30.311
WY$32.311

How the 97535 rate is calculated

Each of 97535’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 · 97535

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.45

0.45 RVUs× 1.000 GPCI

Practice expense0.51

0.51 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.9700

Conversion factor

$33.4009

Medicare rate

$32.40

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

Payment rules and modifiers for 97535

The CMS indicators that decide how 97535 is paid alongside other services.

CMS payment indicators · 97535

Self-care training, ADL and home management, per 15 minutes

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

97535 without CQ · national office

$32.40

Self-care training, ADL and home management, per 15 minutes

97535-CQ · Allowed amount unchanged

$32.40

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.

97535 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 97535

    Self-care training, ADL and home management, per 15 minutes0.45 wRVU

    $32.40

  • 97530

    Therapeutic activities, one-on-one, each 15 minutes0.44 wRVU

    $35.07+$2.67

  • 97537

    Reintegration training, community or work skills0.48 wRVU

    $32.06−$0.34

  • 97542

    Wheelchair training, assessment, fitting, and use0.48 wRVU

    $31.06−$1.34

  • 97550

    Caregiver training, initial 30 minutes1 wRVU

    $52.77+$20.37

How to choose

97530Therapeutic activitiesOne-on-one, each 15 minutes
97535 teaches specific ADL and home management skills; 97530 uses dynamic activities to improve functional performance. Select the code that matches the documented treatment.
97537Reintegration trainingCommunity or work skills
97537 addresses community or workplace participation, such as using public transportation or practicing workplace routines. 97535 addresses personal care and home management tasks.
97542Wheelchair trainingAssessment, fitting, and use
Wheelchair propulsion and management training belongs to 97542. Teaching a patient to perform personal care tasks while seated in a wheelchair may instead support 97535.
97550Caregiver trainingInitial 30 minutes
97550 describes qualifying caregiver training without the patient present, beginning with the first 30 minutes. 97535 is direct, one-on-one training of the patient in self-care or home management.

Codes related to 97535

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

Codes related to 97535
CodeHow it relatesNational office range
Often billed with
97530Therapeutic activities, one-on-one, each 15 minutesTherapeutic activities may accompany ADL training when each service has separately documented treatment time.$32.08–$45.39
97165OT evaluation, low complexityA low-complexity OT evaluation may occur alongside separate, medically necessary self-care training.$93.50–$129.28
97110Therapeutic exercise, one-on-one, each 15 minutesTherapeutic exercise for strength or range of motion may be paired with separately timed ADL training.$26.97–$37.31
Same family
97542Wheelchair training, assessment, fitting, and useSibling training code focused on wheelchair management rather than self-care tasks.$28.83–$39.88
97537Reintegration training, community or work skillsSibling code for community and work reintegration training.$29.69–$40.95
Used instead
97550Caregiver training, initial 30 minutesDescribes qualifying training of caregivers without the patient present instead of direct patient training.$49.93–$70.56
97760Orthotic training, initial encounterUsed instead when training centers on orthotic management and use.$41.83–$60.62

97535 billing questions

How is this code different from 97530 therapeutic activities?

Use 97535 for instruction in a specific self-care or home task, such as dressing or using a tub bench. Use 97530 for dynamic activities, such as lifting or transfer practice, directed at improving functional performance rather than teaching that task.

Can time spent training a family member be counted?

Count only direct, one-on-one training furnished to the patient toward 97535. For qualifying training furnished to caregivers without the patient present, 97550 describes the first 30 minutes; 97551 covers additional 15-minute increments.

Which therapy modifier identifies the plan of care?

Use GO for an occupational therapy plan of care or GP for a physical therapy plan of care. Use GN if the service is furnished under a speech-language pathology plan of care.

How many units can be billed for a session?

Medicare determines the day's allowable timed therapy units from total direct timed therapy minutes. Document the actual minutes of 97535 separately so the units can be allocated to the services furnished.

Is instruction in adaptive equipment use reported here?

Yes, patient training in equipment used for daily living, such as a reacher or tub bench, can be reported with 97535. Use 97542 for wheelchair management training and 97760 for orthotic management and training.

97535 is in these specialty bundles: Physical therapy

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 97535PPRRVU2026_Oct_nonQPP.csv, line 12,891 (RVU26D)

Open CMS sourceHow we calculate rates

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