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

In Kentucky, Medicare pays $30.48 for 97535 in the office.

Check a contract rate as a % of Medicare · 97535 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 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.

How Kentucky compares for 97535

Across 109 of 109 payment localities, the office rate for 97535 runs from $29.84 in Arkansas to $41.43 in San Benito County, CA. Kentucky pays $30.48. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

97535 rates by state

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

See 97535 in every payment locality

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.

Payment rules and modifiers for 97535

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

What modifiers do to the payment

97535 compared with similar codes

Same family in Kentucky

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.

How 97535 has changed in Kentucky

Price 97535 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

• Adairville
• Ages
• Albany
• Alexandria
• Allen
• Allensville
• Anchorage
• Annville

Browse all communities in Kentucky

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