CPT code 97537: Reintegration training, community or work skills2026 Medicare rate & RVUs in Rhode Island
Reports skilled, one-on-one training that helps a patient manage practical activities in community settings or prepare for participation in a work environment.
In Rhode Island, Medicare pays $32.85 for 97537 in the office.
Check a contract rate as a % of Medicare · 97537 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 97537 covers
A therapist works directly with the patient on functional skills needed outside the clinic, such as navigating public transportation, shopping, managing money, or carrying out tasks related to a work setting. Work-focused services may include analyzing job tasks or the work environment and training the patient to use adaptive equipment. Occupational therapists commonly provide this rehabilitation service; physical therapists may provide it when the training fits the plan of care. Activities address the patient’s functional goals rather than general exercise alone.
Report one unit for each 15 minutes of direct, one-on-one service. Documentation should identify the activity practiced, its connection to the patient’s functional goals, the skilled instruction or adaptation provided, and the treatment time. Distinguish community or work reintegration from self-care instruction, general therapeutic activities, and work-hardening programs based on the activity and purpose. The professional component modifier does not apply to this therapy service. When multiple therapy units are reported on the same day, CMS reduces practice expense for the second and later units.
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 Rhode Island compares for 97537
Across 109 of 109 payment localities, the office rate for 97537 runs from $29.69 in Arkansas to $40.95 in Alaska. Rhode Island pays $32.85. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Rhode Island · this page$32.85
- Los Angeles, CA · California$35.48+$2.63
- Washington, DC area · District of Columbia$35.76+$2.91
- Miami, FL · Florida$33.22+$0.37
- Chicago, IL · Illinois$32.69−$0.16
- Manhattan, NY · New York$35.83+$2.98
- Alaska · Alaska$40.95+$8.10
Other areas in Rhode Island first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $29.96 | — |
| ArkansasArkansas | $29.69 | — |
| ArizonaArizona | $31.53 | — |
| Bakersfield, CACalifornia | $33.75 | — |
| Chico, CACalifornia | $33.69 | — |
| El Centro, CACalifornia | $33.69 | — |
| Fresno, CACalifornia | $33.69 | — |
| Hanford, CACalifornia | $33.69 | — |
| Madera, CACalifornia | $33.69 | — |
| Merced, CACalifornia | $33.69 | — |
| Modesto, CACalifornia | $33.69 | — |
| Napa, CACalifornia | $37.90 | — |
| Oxnard, CACalifornia | $35.24 | — |
| Redding, CACalifornia | $33.69 | — |
| Rest of CaliforniaCalifornia | $33.69 | — |
| Riverside, CACalifornia | $33.81 | — |
| Sacramento, CACalifornia | $35.05 | — |
| Salinas, CACalifornia | $34.90 | — |
| San Diego, CACalifornia | $35.47 | — |
| Marin County, CACalifornia | $39.84 | — |
| San Francisco, CACalifornia | $39.83 | — |
| San Benito County, CACalifornia | $40.61 | — |
| Santa Clara County, CACalifornia | $40.57 | — |
| San Luis Obispo, CACalifornia | $34.36 | — |
| Santa Cruz, CACalifornia | $35.62 | — |
| Santa Maria, CACalifornia | $34.96 | — |
| Santa Rosa, CACalifornia | $35.97 | — |
| Stockton, CACalifornia | $33.69 | — |
| Vallejo, CACalifornia | $37.89 | — |
| Visalia, CACalifornia | $33.69 | — |
| Yuba City, CACalifornia | $33.69 | — |
| ColoradoColorado | $33.19 | — |
| ConnecticutConnecticut | $33.66 | — |
| DelawareDelaware | $31.92 | — |
| Fort Lauderdale, FLFlorida | $32.54 | — |
| Rest of FloridaFlorida | $31.54 | — |
| Atlanta, GAGeorgia | $32.43 | — |
| Rest of GeorgiaGeorgia | $30.43 | — |
| Hawaii, Guam, HIHawaii | $34.07 | — |
| IowaIowa | $30.53 | — |
| IdahoIdaho | $30.63 | — |
| East St. Louis, ILIllinois | $31.15 | — |
| Rest of IllinoisIllinois | $30.89 | — |
| Suburban Chicago, ILIllinois | $32.86 | — |
| IndianaIndiana | $30.75 | — |
| KansasKansas | $30.39 | — |
| KentuckyKentucky | $30.29 | — |
| New Orleans, LALouisiana | $31.18 | — |
| Rest of LouisianaLouisiana | $30.25 | — |
| Metropolitan Boston, MAMassachusetts | $35.73 | — |
| Rest of MassachusettsMassachusetts | $33.09 | — |
| Baltimore area, MDMaryland | $33.55 | — |
| Rest of MarylandMaryland | $32.39 | — |
| Rest of MaineMaine | $30.68 | — |
| Southern Maine, MEMaine | $31.80 | — |
| Detroit, MIMichigan | $31.74 | — |
| Rest of MichiganMichigan | $30.74 | — |
| MinnesotaMinnesota | $32.28 | — |
| Metropolitan Kansas City, MOMissouri | $31.10 | — |
| Metropolitan St. Louis, MOMissouri | $31.31 | — |
| Rest of MissouriMissouri | $29.89 | — |
| MississippiMississippi | $29.80 | — |
| MontanaMontana | $32.06 | — |
| North CarolinaNorth Carolina | $30.89 | — |
| North DakotaNorth Dakota | $31.87 | — |
| NebraskaNebraska | $30.65 | — |
| New HampshireNew Hampshire | $32.67 | — |
| Northern New JerseyNew Jersey | $35.61 | — |
| Rest of New JerseyNew Jersey | $34.18 | — |
| New MexicoNew Mexico | $30.83 | — |
| NevadaNevada | $32.02 | — |
| NYC suburbs and Long Island, NYNew York | $36.34 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $34.35 | — |
| Queens, NYNew York | $36.10 | — |
| Rest of New YorkNew York | $31.18 | — |
| OhioOhio | $30.70 | — |
| OklahomaOklahoma | $30.31 | — |
| Portland, OROregon | $33.98 | — |
| Rest of OregonOregon | $31.90 | — |
| Metropolitan Philadelphia, PAPennsylvania | $33.06 | — |
| Rest of PennsylvaniaPennsylvania | $30.76 | — |
| Puerto RicoPuerto Rico | $32.23 | — |
| South CarolinaSouth Carolina | $30.82 | — |
| South DakotaSouth Dakota | $31.84 | — |
| TennesseeTennessee | $30.48 | — |
| Austin, TXTexas | $32.97 | — |
| Beaumont, TXTexas | $30.63 | — |
| Brazoria, TXTexas | $31.98 | — |
| Dallas, TXTexas | $32.10 | — |
| Fort Worth, TXTexas | $31.95 | — |
| Galveston, TXTexas | $32.03 | — |
| Houston, TXTexas | $32.21 | — |
| Rest of TexasTexas | $31.23 | — |
| UtahUtah | $31.09 | — |
| VirginiaVirginia | $31.70 | — |
| Virgin Islands, VIUnited States Virgin Islands | $32.23 | — |
| VermontVermont | $31.74 | — |
| Rest of WashingtonWashington | $33.03 | — |
| King County, WAWashington | $36.37 | — |
| WisconsinWisconsin | $31.17 | — |
| West VirginiaWest Virginia | $30.15 | — |
| WyomingWyoming | $31.98 | — |
97537 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.
$29.69
$40.95
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $40.95 | 1 |
| AL | $29.96 | 1 |
| AR | $29.69 | 1 |
| AZ | $31.53 | 1 |
| CA | $33.69–$40.61 | 29 |
| CO | $33.19 | 1 |
| CT | $33.66 | 1 |
| DC | $35.76 | 1 |
| DE | $31.92 | 1 |
| FL | $31.54–$33.22 | 3 |
| GA | $30.43–$32.43 | 2 |
| GU | $34.07 | 1 |
| HI | $34.07 | 1 |
| IA | $30.53 | 1 |
| ID | $30.63 | 1 |
| IL | $30.89–$32.86 | 4 |
| IN | $30.75 | 1 |
| KS | $30.39 | 1 |
| KY | $30.29 | 1 |
| LA | $30.25–$31.18 | 2 |
| MA | $33.09–$35.73 | 2 |
| MD | $32.39–$35.76 | 3 |
| ME | $30.68–$31.80 | 2 |
| MI | $30.74–$31.74 | 2 |
| MN | $32.28 | 1 |
| MO | $29.89–$31.31 | 3 |
| MS | $29.80 | 1 |
| MT | $32.06 | 1 |
| NC | $30.89 | 1 |
| ND | $31.87 | 1 |
| NE | $30.65 | 1 |
| NH | $32.67 | 1 |
| NJ | $34.18–$35.61 | 2 |
| NM | $30.83 | 1 |
| NV | $32.02 | 1 |
| NY | $31.18–$36.34 | 5 |
| OH | $30.70 | 1 |
| OK | $30.31 | 1 |
| OR | $31.90–$33.98 | 2 |
| PA | $30.76–$33.06 | 2 |
| PR | $32.23 | 1 |
| RI | $32.85 | 1 |
| SC | $30.82 | 1 |
| SD | $31.84 | 1 |
| TN | $30.48 | 1 |
| TX | $30.63–$32.97 | 8 |
| UT | $31.09 | 1 |
| VA | $31.70–$35.76 | 2 |
| VI | $32.23 | 1 |
| VT | $31.74 | 1 |
| WA | $33.03–$36.37 | 2 |
| WI | $31.17 | 1 |
| WV | $30.15 | 1 |
| WY | $31.98 | 1 |
How the 97537 rate is calculated
Each of 97537’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 · 97537
RVUs × geographic indexes × conversion factor
Work0.48
0.48 RVUs× 1.000 GPCI
Practice expense0.47
0.47 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.9600
Conversion factor
$33.4009
Medicare rate
$32.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Rhode Island inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,892
- Code
- 97537
- Physician work
- 0.48
- Practice expense
- 0.47
- Malpractice
- 0.01
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.48 | × 1.019 | 0.4891 |
| Practice expense | 0.47 | × 1.033 | 0.4855 |
| Malpractice | 0.01 | × 0.892 | 0.0089 |
| Total RVUs | 0.9835 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Rhode Island$32.85
Office: (0.48 × 1.019 + 0.47 × 1.033 + 0.01 × 0.892) × $33.4009 = $32.85
Payment rules and modifiers for 97537
The CMS indicators that decide how 97537 is paid alongside other services.
CMS payment indicators · 97537
Reintegration training, community or work skills
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 5 | Therapy reduction: practice expense of the second and later units is reduced. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 7 | Therapy service: the split doesn’t apply. |
What modifiers do to the payment
Modifier CQ · payment effect
With and without the modifier
97537 without CQ · national office
$32.06
Reintegration training, community or work skills
97537-CQ · Allowed amount unchanged
$32.06
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 97537 has changed in Rhode Island
97537 · Office / nonfacility
$32.85
Effective 2026-10-01
The base rate is $0.19 higher than on 2025-10-01, moving from $32.66 to $32.85 (0.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$32.66changed to$32.85
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.49 changed to 0.47
- Work GPCI 1.025 changed to 1.019
- Practice expense GPCI 1.039 changed to 1.033
- Malpractice GPCI 0.849 changed to 0.892
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$32.57changed to$32.66
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.46 changed to 0.49
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$32.04changed to$32.57
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$33.22changed to$32.04
- Conversion factor 33.8872 changed to 32.7442
- Work GPCI 1.023 changed to 1.025
- Practice expense GPCI 1.044 changed to 1.039
- Malpractice GPCI 0.915 changed to 0.849
January 1, 2023
RVU23A
$33.60changed to$33.22
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.44 changed to 0.46
- Malpractice RVU 0.02 changed to 0.01
- Work GPCI 1.021 changed to 1.023
- Practice expense GPCI 1.048 changed to 1.044
- Malpractice GPCI 0.981 changed to 0.915
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$33.51changed to$33.60
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.43 changed to 0.44
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$34.73changed to$33.51
- Conversion factor 36.0896 changed to 34.8931
- Work GPCI 1.024 changed to 1.021
- Practice expense GPCI 1.049 changed to 1.048
- Malpractice GPCI 0.990 changed to 0.981
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$34.76changed to$34.73
- Conversion factor 36.0391 changed to 36.0896
- Work GPCI 1.027 changed to 1.024
- Practice expense GPCI 1.050 changed to 1.049
- Malpractice GPCI 0.999 changed to 0.990
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$35.10changed to$34.76
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.44 changed to 0.43
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$31.91changed to$35.10
- Conversion factor 35.8887 changed to 35.9996
- Work RVU 0.45 changed to 0.48
- Practice expense RVU 0.39 changed to 0.44
- Work GPCI 1.025 changed to 1.027
- Practice expense GPCI 1.052 changed to 1.050
- Malpractice GPCI 0.879 changed to 0.999
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$31.34changed to$31.91
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.38 changed to 0.39
- Work GPCI 1.022 changed to 1.025
- Practice expense GPCI 1.053 changed to 1.052
- Malpractice GPCI 0.759 changed to 0.879
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$31.56changed to$31.34
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.39 changed to 0.38
- Malpractice RVU 0.01 changed to 0.02
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$31.40changed to$31.56
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$31.50changed to$31.40
- Conversion factor 35.8228 changed to 35.7547
- Work GPCI 1.020 changed to 1.022
- Malpractice GPCI 0.973 changed to 0.759
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$31.50
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $32.85 | Not available in this setting | RVU26D |
| 2026-07-01 | $32.85 | Not available in this setting | RVU26C |
| 2026-04-01 | $32.85 | Not available in this setting | RVU26B |
| 2026-01-01 | $32.85 | Not available in this setting | RVU26A |
| 2025-10-01 | $32.66 | Not available in this setting | RVU25D |
| 2025-07-01 | $32.66 | Not available in this setting | RVU25C |
| 2025-04-01 | $32.66 | Not available in this setting | RVU25B |
| 2025-01-01 | $32.66 | Not available in this setting | RVU25A |
| 2024-10-01 | $32.57 | Not available in this setting | RVU24D |
| 2024-07-01 | $32.57 | Not available in this setting | RVU24C |
| 2024-04-01 | $32.57 | Not available in this setting | RVU24B |
| 2024-03-09 | $32.57 | Not available in this setting | RVU24AR |
| 2024-01-01 | $32.04 | Not available in this setting | RVU24A |
| 2023-10-01 | $33.22 | Not available in this setting | RVU23D |
| 2023-07-01 | $33.22 | Not available in this setting | RVU23C |
| 2023-04-01 | $33.22 | Not available in this setting | RVU23B |
| 2023-01-01 | $33.22 | Not available in this setting | RVU23A |
| 2022-10-01 | $33.60 | Not available in this setting | RVU22D |
| 2022-07-01 | $33.60 | Not available in this setting | RVU22C |
| 2022-04-01 | $33.60 | Not available in this setting | RVU22B |
| 2022-01-01 | $33.60 | Not available in this setting | RVU22A |
| 2021-10-01 | $33.51 | Not available in this setting | RVU21D |
| 2021-07-01 | $33.51 | Not available in this setting | RVU21C |
| 2021-04-01 | $33.51 | Not available in this setting | RVU21B |
| 2021-01-01 | $33.51 | Not available in this setting | RVU21A |
| 2020-10-01 | $34.73 | Not available in this setting | RVU20D |
| 2020-07-01 | $34.73 | Not available in this setting | RVU20C |
| 2020-04-01 | $34.73 | Not available in this setting | RVU20B |
| 2020-01-01 | $34.73 | Not available in this setting | RVU20A |
| 2019-10-01 | $34.76 | Not available in this setting | RVU19D |
| 2019-07-01 | $34.76 | Not available in this setting | RVU19C |
| 2019-04-01 | $34.76 | Not available in this setting | RVU19B |
| 2019-01-01 | $34.76 | Not available in this setting | RVU19A |
| 2018-10-01 | $35.10 | Not available in this setting | RVU18D |
| 2018-07-01 | $35.10 | Not available in this setting | RVU18C |
| 2018-04-01 | $35.10 | Not available in this setting | RVU18B |
| 2018-01-01 | $35.10 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $31.91 | Not available in this setting | RVU17D |
| 2017-07-01 | $31.91 | Not available in this setting | RVU17C |
| 2017-04-01 | $31.91 | Not available in this setting | RVU17B |
| 2017-01-01 | $31.91 | Not available in this setting | RVU17A |
| 2016-10-01 | $31.34 | Not available in this setting | RVU16D |
| 2016-07-01 | $31.34 | Not available in this setting | RVU16C |
| 2016-04-01 | $31.34 | Not available in this setting | RVU16B |
| 2016-01-01 | $31.34 | Not available in this setting | RVU16A |
| 2015-10-01 | $31.56 | Not available in this setting | RVU15D |
| 2015-07-01 | $31.56 | Not available in this setting | RVU15C |
| 2015-04-01 | $31.40 | Not available in this setting | RVU15B |
| 2015-01-01 | $31.40 | Not available in this setting | RVU15A |
| 2014-10-01 | $31.50 | Not available in this setting | RVU14D |
| 2014-07-01 | $31.50 | Not available in this setting | RVU14C |
| 2014-04-01 | $31.50 | Not available in this setting | RVU14B |
| 2014-01-01 | $31.50 | Not available in this setting | RVU14A |
| 2013-10-01 | Rate data unavailable | Not available in this setting | RVU13D |
| 2013-07-01 | Rate data unavailable | Not available in this setting | RVU13C |
| 2013-04-01 | Rate data unavailable | Not available in this setting | RVU13B |
| 2013-01-01 | Rate data unavailable | Not available in this setting | RVU13AR |
Where the Rhode Island rate applies
Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.
- Ashaway
- Bradford
- Carolina
- Central Falls
- Charlestown
- Chepachet
- Clayville
- Cranston
97537 billing questions
How does this differ from self-care training?
Use this code for skilled practice of community or work-related activities, such as transportation or job-task adaptation. Self-care training focuses on activities such as dressing, bathing, or other personal care tasks.
Is each unit 15 minutes?
Yes. Report one unit for each 15 minutes of direct, one-on-one training, supported by documentation of the activity and treatment time.
Can this be reported with therapeutic activities on the same day?
They may be reported when each service is distinct and separately supported. Document the reintegration task separately from the therapeutic activity and account for all treatment time.
Does a professional component modifier apply?
No. CMS identifies this as a therapy service for which the professional component modifier does not apply.
How does the therapy multiple procedure reduction affect payment?
For multiple therapy units on the same day, CMS reduces practice expense for the second and later units. The rule concerns practice expense.
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
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