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

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, 2026One payment locality3.9M Medicare services in 2024

In South Dakota, Medicare pays $32.18 for 97535 in the office.

$32.18Office (non-facility)
Not available in this settingHospital or facility
−0.7%vs the national office rate ($32.40)

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.

We’ll open 97535 for the payment locality that covers the ZIP.

On this page 12 sections
  1. Rate in South Dakota
  2. What 97535 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Rate history
  10. Where it applies
  11. Billing questions
  12. 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

How South Dakota 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. South Dakota pays $32.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

97535 in South Dakota vs other payment areas
  1. South Dakota · this page$32.18
  2. Los Angeles, CA · California$36.02+$3.84
  3. Washington, DC area · District of Columbia$36.28+$4.10
  4. Miami, FL · Florida$33.61+$1.43
  5. Chicago, IL · Illinois$33.02+$0.84
  6. Manhattan, NY · New York$36.32+$4.14
  7. Alaska · Alaska$40.87+$8.69

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

Every other payment area

97535 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$30.12—
ArkansasArkansas$29.84—
ArizonaArizona$31.82—
Bakersfield, CACalifornia$34.19—
Chico, CACalifornia$34.13—
El Centro, CACalifornia$34.14—
Fresno, CACalifornia$34.13—
Hanford, CACalifornia$34.13—

97535 rates by state

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

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

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.

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.

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,891

Code
97535
Physician work
0.45
Practice expense
0.51
Malpractice
0.01

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 97535 in South Dakota
ComponentRVULocality factorAdjusted
Physician work0.45× 1.0000.4500
Practice expense0.51× 1.0000.5100
Malpractice0.01× 0.3360.0034
Total RVUs0.9634
Conversion factor× 33.4009

Office rate, South Dakota$32.18

Office: (0.45 × 1 + 0.51 × 1 + 0.01 × 0.336) × $33.4009 = $32.18

Open 97535 in the RVU calculator

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

  • 97110

    Therapeutic exercise, one-on-one, each 15 minutes0.45 wRVU

    $29.06−$3.34

  • 97112

    Neuromuscular reeducation, balance, coordination, proprioception, timed0.5 wRVU

    $32.73+$0.33

  • 97140

    Manual therapy, one or more regions, each 15 minutes0.43 wRVU

    $27.72−$4.68

  • 97530

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

    $35.07+$2.67

Same family in South Dakota

Related code rates in South Dakota
CodeOfficeFacility
97110Therapeutic exerciseOne-on-one, each 15 minutes$28.84Not available in this setting
97112Neuromuscular reeducationBalance, coordination, proprioception, timed$32.51Not available in this setting
97140Manual therapyOne or more regions, each 15 minutes$27.50Not available in this setting
97530Therapeutic activitiesOne-on-one, each 15 minutes$34.85Not available in this setting

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.

How 97535 has changed in South Dakota

97535 · Office / nonfacility

$32.18

Effective 2026-10-01

The base rate is $0.36 higher than on 2025-10-01, moving from $31.82 to $32.18 (1.1%).

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

    $31.82changed to$32.18

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.53 changed to 0.51
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $32.42changed to$31.82

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.52 changed to 0.53

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $31.89changed to$32.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $32.99changed to$31.89

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $33.12changed to$32.99

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.50 changed to 0.52
    • Malpractice RVU 0.02 changed to 0.01
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $33.39changed to$33.12

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $34.55changed to$33.39

    • Conversion factor 36.0896 changed to 34.8931
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $34.52changed to$34.55

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $34.84changed to$34.52

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.51 changed to 0.50

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $35.10changed to$34.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.52 changed to 0.51
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $35.02changed to$35.10

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $35.00changed to$35.02

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.01 changed to 0.02

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $34.83changed to$35.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $34.90changed to$34.83

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $34.51changed to$34.90

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.56 changed to 0.52
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $34.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$32.18Not available in this settingRVU26D
2026-07-01$32.18Not available in this settingRVU26C
2026-04-01$32.18Not available in this settingRVU26B
2026-01-01$32.18Not available in this settingRVU26A
2025-10-01$31.82Not available in this settingRVU25D
2025-07-01$31.82Not available in this settingRVU25C
2025-04-01$31.82Not available in this settingRVU25B
2025-01-01$31.82Not available in this settingRVU25A
2024-10-01$32.42Not available in this settingRVU24D
2024-07-01$32.42Not available in this settingRVU24C
2024-04-01$32.42Not available in this settingRVU24B
2024-03-09$32.42Not available in this settingRVU24AR
2024-01-01$31.89Not available in this settingRVU24A
2023-10-01$32.99Not available in this settingRVU23D
2023-07-01$32.99Not available in this settingRVU23C
2023-04-01$32.99Not available in this settingRVU23B
2023-01-01$32.99Not available in this settingRVU23A
2022-10-01$33.12Not available in this settingRVU22D
2022-07-01$33.12Not available in this settingRVU22C
2022-04-01$33.12Not available in this settingRVU22B
2022-01-01$33.12Not available in this settingRVU22A
2021-10-01$33.39Not available in this settingRVU21D
2021-07-01$33.39Not available in this settingRVU21C
2021-04-01$33.39Not available in this settingRVU21B
2021-01-01$33.39Not available in this settingRVU21A
2020-10-01$34.55Not available in this settingRVU20D
2020-07-01$34.55Not available in this settingRVU20C
2020-04-01$34.55Not available in this settingRVU20B
2020-01-01$34.55Not available in this settingRVU20A
2019-10-01$34.52Not available in this settingRVU19D
2019-07-01$34.52Not available in this settingRVU19C
2019-04-01$34.52Not available in this settingRVU19B
2019-01-01$34.52Not available in this settingRVU19A
2018-10-01$34.84Not available in this settingRVU18D
2018-07-01$34.84Not available in this settingRVU18C
2018-04-01$34.84Not available in this settingRVU18B
2018-01-01$34.84Not available in this settingRVU18AR1
2017-10-01$35.10Not available in this settingRVU17D
2017-07-01$35.10Not available in this settingRVU17C
2017-04-01$35.10Not available in this settingRVU17B
2017-01-01$35.10Not available in this settingRVU17A
2016-10-01$35.02Not available in this settingRVU16D
2016-07-01$35.02Not available in this settingRVU16C
2016-04-01$35.02Not available in this settingRVU16B
2016-01-01$35.02Not available in this settingRVU16A
2015-10-01$35.00Not available in this settingRVU15D
2015-07-01$35.00Not available in this settingRVU15C
2015-04-01$34.83Not available in this settingRVU15B
2015-01-01$34.83Not available in this settingRVU15A
2014-10-01$34.90Not available in this settingRVU14D
2014-07-01$34.90Not available in this settingRVU14C
2014-04-01$34.90Not available in this settingRVU14B
2014-01-01$34.90Not available in this settingRVU14A
2013-10-01$34.51Not available in this settingRVU13D
2013-07-01$34.51Not available in this settingRVU13C
2013-04-01$34.51Not available in this settingRVU13B
2013-01-01$34.51Not available in this settingRVU13AR

Price 97535 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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