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CPT code 97542: Wheelchair training, assessment, fitting, and use2026 Medicare rate & RVUs

A therapist assesses wheelchair needs, fits or adjusts the chair, and trains the patient to use it safely and effectively.

CMS RVU26DEffective Oct 1, 2026109 payment localities130K Medicare services in 2024

Medicare pays $31.06 for 97542 nationally in the office. Local office rates run $28.83–$39.88.

Medicare rate · 97542

Wheelchair training, assessment, fitting, and use

Office or facility?

Work RVUs
0.48
Total RVUs
0.93
Global days
XXX

National rate · 2026

$31.06

Office setting, before claim adjustments.

See every locality for 97542 →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 97542 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 97542 covers

Physical and occupational therapists use this service to assess a patient’s wheelchair needs, fit or adjust the chair, and provide skilled training in its use. Training may address safe operation, propulsion, and maneuvering in the patient’s mobility environment. It is commonly furnished in outpatient rehabilitation clinics and hospital settings when a patient needs instruction or an individualized wheelchair setup to support mobility.

Report the service in 15-minute units for skilled wheelchair assessment, fitting, or use training, and document the intervention, time, and patient’s response or progress. Distinguish wheelchair-specific instruction from broader self-care training or therapeutic activities. This is a therapy service, so a professional-component modifier does not apply. Under the therapy multiple procedure payment reduction, CMS reduces the practice-expense portion 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.

Where 97542 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

$28.83 to $39.88

$28.83$34.36$39.88
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

97542 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$29.08Unavailable
Alaska$39.88Unavailable
Arizona$30.56Unavailable
Arkansas$28.83Unavailable
Atlanta, GA$31.41Unavailable
Austin, TX$31.91Unavailable
Bakersfield, CA$32.65Unavailable
Baltimore area, MD$32.47Unavailable
Beaumont, TX$29.72Unavailable
Brazoria, TX$30.99Unavailable

97542 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$28.83

$39.88

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

View every state and territory as a table
97542 office rate range by state
State / territoryOffice rate rangeLocalities
AK$39.881
AL$29.081
AR$28.831
AZ$30.561
CA$32.59–$39.1729
CO$32.121
CT$32.591
DC$34.581
DE$30.931
FL$30.58–$32.183
GA$29.54–$31.412
GU$32.941
HI$32.941
IA$29.611
ID$29.711
IL$29.97–$31.834
IN$29.821
KS$29.491
KY$29.401
LA$29.36–$30.242
MA$32.03–$34.532
MD$31.37–$34.583
ME$29.76–$30.812
MI$29.83–$30.782
MN$31.251
MO$29.03–$30.363
MS$28.931
MT$31.061
NC$29.961
ND$30.861
NE$29.721
NH$31.621
NJ$33.09–$34.452
NM$29.911
NV$31.021
NY$30.23–$35.155
OH$29.791
OK$29.421
OR$30.90–$32.872
PA$29.84–$32.022
PR$31.221
RI$31.821
SC$29.901
SD$30.841
TN$29.571
TX$29.72–$31.918
UT$30.151
VA$30.71–$34.582
VI$31.221
VT$30.751
WA$31.97–$35.142
WI$30.211
WV$29.281
WY$30.981

How the 97542 rate is calculated

Each of 97542’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 · 97542

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.48

0.48 RVUs× 1.000 GPCI

Practice expense0.44

0.44 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.9300

Conversion factor

$33.4009

Medicare rate

$31.06

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

Payment rules and modifiers for 97542

The CMS indicators that decide how 97542 is paid alongside other services.

CMS payment indicators · 97542

Wheelchair training, assessment, fitting, and use

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

97542 without CQ · national office

$31.06

Wheelchair training, assessment, fitting, and use

97542-CQ · Allowed amount unchanged

$31.06

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.

97542 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 97542

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

    $31.06

  • 97535

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

    $32.40+$1.34

  • 97530

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

    $35.07+$4.01

  • 97537

    Reintegration training, community or work skills0.48 wRVU

    $32.06+$1.00

How to choose

97535Self-care trainingADL and home management, per 15 minutes
Choose 97542 for wheelchair assessment, fitting, and use instruction. Choose 97535 when the skilled intervention trains self-care or daily living tasks.
97530Therapeutic activitiesOne-on-one, each 15 minutes
97530 covers dynamic therapeutic activities; 97542 is specific to wheelchair assessment, fitting, or use training.
97537Reintegration trainingCommunity or work skills
97537 focuses on community or work reintegration activities. Use 97542 for wheelchair-specific assessment, fitting, and instruction.

Codes related to 97542

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

Codes related to 97542
CodeHow it relatesNational office range
Used instead
97535Self-care training, ADL and home management, per 15 minutesUse for skilled self-care training when the focus is daily living tasks rather than wheelchair assessment or use.$29.84–$41.43
97537Reintegration training, community or work skillsAddresses community or work reintegration rather than wheelchair fitting and use instruction.$29.69–$40.95
Often billed with
97530Therapeutic activities, one-on-one, each 15 minutesMay accompany distinct therapeutic activities separate from wheelchair-specific assessment or training.$32.08–$45.39

97542 billing questions

When should I report wheelchair training instead of self-care training?

Report this code for skilled assessment, fitting, or instruction focused on wheelchair use. Use self-care training when the intervention focuses on daily living tasks rather than wheelchair-specific skills.

Is this code reported in timed units?

Yes. The service is reported in 15-minute units. Document the skilled wheelchair intervention and the time supporting the units billed.

Can wheelchair training and therapeutic activities be reported on the same date?

They may be reported together when each represents a distinct skilled intervention. Document the wheelchair-specific training separately from the therapeutic activities.

Does modifier 26 apply?

No. This is a therapy service, and the professional-component modifier does not apply.

How does the therapy multiple procedure payment reduction affect this code?

For the second and later therapy units furnished on the same day, CMS reduces the practice-expense portion of payment.

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 97542PPRRVU2026_Oct_nonQPP.csv, line 12,893 (RVU26D)

Open CMS sourceHow we calculate rates

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