CPT code 97542: Wheelchair training, assessment, fitting, and use2026 Medicare rate & RVUs in Connecticut
A therapist assesses wheelchair needs, fits or adjusts the chair, and trains the patient to use it safely and effectively.
In Connecticut, Medicare pays $32.59 for 97542 in the office.
Check a contract rate as a % of Medicare · 97542 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 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.
How Connecticut compares for 97542
Across 109 of 109 payment localities, the office rate for 97542 runs from $28.83 in Arkansas to $39.88 in Alaska. Connecticut pays $32.59. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Connecticut · this page$32.59
- Los Angeles, CA · California$34.30+$1.71
- Washington, DC area · District of Columbia$34.58+$1.99
- Miami, FL · Florida$32.18−$0.41
- Chicago, IL · Illinois$31.68−$0.91
- Manhattan, NY · New York$34.67+$2.08
- Alaska · Alaska$39.88+$7.29
Other areas in Connecticut first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $29.08 | — |
| ArkansasArkansas | $28.83 | — |
| ArizonaArizona | $30.56 | — |
| Bakersfield, CACalifornia | $32.65 | — |
| Chico, CACalifornia | $32.59 | — |
| El Centro, CACalifornia | $32.59 | — |
| Fresno, CACalifornia | $32.59 | — |
| Hanford, CACalifornia | $32.59 | — |
| Madera, CACalifornia | $32.59 | — |
| Merced, CACalifornia | $32.59 | — |
| Modesto, CACalifornia | $32.59 | — |
| Napa, CACalifornia | $36.58 | — |
| Oxnard, CACalifornia | $34.06 | — |
| Redding, CACalifornia | $32.59 | — |
| Rest of CaliforniaCalifornia | $32.59 | — |
| Riverside, CACalifornia | $32.71 | — |
| Sacramento, CACalifornia | $33.88 | — |
| Salinas, CACalifornia | $33.74 | — |
| San Diego, CACalifornia | $34.27 | — |
| Marin County, CACalifornia | $38.43 | — |
| San Francisco, CACalifornia | $38.42 | — |
| San Benito County, CACalifornia | $39.17 | — |
| Santa Clara County, CACalifornia | $39.12 | — |
| San Luis Obispo, CACalifornia | $33.22 | — |
| Santa Cruz, CACalifornia | $34.40 | — |
| Santa Maria, CACalifornia | $33.80 | — |
| Santa Rosa, CACalifornia | $34.74 | — |
| Stockton, CACalifornia | $32.59 | — |
| Vallejo, CACalifornia | $36.57 | — |
| Visalia, CACalifornia | $32.59 | — |
| Yuba City, CACalifornia | $32.59 | — |
| ColoradoColorado | $32.12 | — |
| DelawareDelaware | $30.93 | — |
| Fort Lauderdale, FLFlorida | $31.52 | — |
| Rest of FloridaFlorida | $30.58 | — |
| Atlanta, GAGeorgia | $31.41 | — |
| Rest of GeorgiaGeorgia | $29.54 | — |
| Hawaii, Guam, HIHawaii | $32.94 | — |
| IowaIowa | $29.61 | — |
| IdahoIdaho | $29.71 | — |
| East St. Louis, ILIllinois | $30.23 | — |
| Rest of IllinoisIllinois | $29.97 | — |
| Suburban Chicago, ILIllinois | $31.83 | — |
| IndianaIndiana | $29.82 | — |
| KansasKansas | $29.49 | — |
| KentuckyKentucky | $29.40 | — |
| New Orleans, LALouisiana | $30.24 | — |
| Rest of LouisianaLouisiana | $29.36 | — |
| Metropolitan Boston, MAMassachusetts | $34.53 | — |
| Rest of MassachusettsMassachusetts | $32.03 | — |
| Baltimore area, MDMaryland | $32.47 | — |
| Rest of MarylandMaryland | $31.37 | — |
| Rest of MaineMaine | $29.76 | — |
| Southern Maine, MEMaine | $30.81 | — |
| Detroit, MIMichigan | $30.78 | — |
| Rest of MichiganMichigan | $29.83 | — |
| MinnesotaMinnesota | $31.25 | — |
| Metropolitan Kansas City, MOMissouri | $30.16 | — |
| Metropolitan St. Louis, MOMissouri | $30.36 | — |
| Rest of MissouriMissouri | $29.03 | — |
| MississippiMississippi | $28.93 | — |
| MontanaMontana | $31.06 | — |
| North CarolinaNorth Carolina | $29.96 | — |
| North DakotaNorth Dakota | $30.86 | — |
| NebraskaNebraska | $29.72 | — |
| New HampshireNew Hampshire | $31.62 | — |
| Northern New JerseyNew Jersey | $34.45 | — |
| Rest of New JerseyNew Jersey | $33.09 | — |
| New MexicoNew Mexico | $29.91 | — |
| NevadaNevada | $31.02 | — |
| NYC suburbs and Long Island, NYNew York | $35.15 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $33.25 | — |
| Queens, NYNew York | $34.91 | — |
| Rest of New YorkNew York | $30.23 | — |
| OhioOhio | $29.79 | — |
| OklahomaOklahoma | $29.42 | — |
| Portland, OROregon | $32.87 | — |
| Rest of OregonOregon | $30.90 | — |
| Metropolitan Philadelphia, PAPennsylvania | $32.02 | — |
| Rest of PennsylvaniaPennsylvania | $29.84 | — |
| Puerto RicoPuerto Rico | $31.22 | — |
| Rhode IslandRhode Island | $31.82 | — |
| South CarolinaSouth Carolina | $29.90 | — |
| South DakotaSouth Dakota | $30.84 | — |
| TennesseeTennessee | $29.57 | — |
| Austin, TXTexas | $31.91 | — |
| Beaumont, TXTexas | $29.72 | — |
| Brazoria, TXTexas | $30.99 | — |
| Dallas, TXTexas | $31.10 | — |
| Fort Worth, TXTexas | $30.96 | — |
| Galveston, TXTexas | $31.03 | — |
| Houston, TXTexas | $31.21 | — |
| Rest of TexasTexas | $30.28 | — |
| UtahUtah | $30.15 | — |
| VirginiaVirginia | $30.71 | — |
| Virgin Islands, VIUnited States Virgin Islands | $31.22 | — |
| VermontVermont | $30.75 | — |
| Rest of WashingtonWashington | $31.97 | — |
| King County, WAWashington | $35.14 | — |
| WisconsinWisconsin | $30.21 | — |
| West VirginiaWest Virginia | $29.28 | — |
| WyomingWyoming | $30.98 | — |
97542 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.
$28.83
$39.88
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 | $39.88 | 1 |
| AL | $29.08 | 1 |
| AR | $28.83 | 1 |
| AZ | $30.56 | 1 |
| CA | $32.59–$39.17 | 29 |
| CO | $32.12 | 1 |
| CT | $32.59 | 1 |
| DC | $34.58 | 1 |
| DE | $30.93 | 1 |
| FL | $30.58–$32.18 | 3 |
| GA | $29.54–$31.41 | 2 |
| GU | $32.94 | 1 |
| HI | $32.94 | 1 |
| IA | $29.61 | 1 |
| ID | $29.71 | 1 |
| IL | $29.97–$31.83 | 4 |
| IN | $29.82 | 1 |
| KS | $29.49 | 1 |
| KY | $29.40 | 1 |
| LA | $29.36–$30.24 | 2 |
| MA | $32.03–$34.53 | 2 |
| MD | $31.37–$34.58 | 3 |
| ME | $29.76–$30.81 | 2 |
| MI | $29.83–$30.78 | 2 |
| MN | $31.25 | 1 |
| MO | $29.03–$30.36 | 3 |
| MS | $28.93 | 1 |
| MT | $31.06 | 1 |
| NC | $29.96 | 1 |
| ND | $30.86 | 1 |
| NE | $29.72 | 1 |
| NH | $31.62 | 1 |
| NJ | $33.09–$34.45 | 2 |
| NM | $29.91 | 1 |
| NV | $31.02 | 1 |
| NY | $30.23–$35.15 | 5 |
| OH | $29.79 | 1 |
| OK | $29.42 | 1 |
| OR | $30.90–$32.87 | 2 |
| PA | $29.84–$32.02 | 2 |
| PR | $31.22 | 1 |
| RI | $31.82 | 1 |
| SC | $29.90 | 1 |
| SD | $30.84 | 1 |
| TN | $29.57 | 1 |
| TX | $29.72–$31.91 | 8 |
| UT | $30.15 | 1 |
| VA | $30.71–$34.58 | 2 |
| VI | $31.22 | 1 |
| VT | $30.75 | 1 |
| WA | $31.97–$35.14 | 2 |
| WI | $30.21 | 1 |
| WV | $29.28 | 1 |
| WY | $30.98 | 1 |
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
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.
The exact Connecticut inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,893
- Code
- 97542
- Physician work
- 0.48
- Practice expense
- 0.44
- Malpractice
- 0.01
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.48 | × 1.020 | 0.4896 |
| Practice expense | 0.44 | × 1.077 | 0.4739 |
| Malpractice | 0.01 | × 1.210 | 0.0121 |
| Total RVUs | 0.9756 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Connecticut$32.59
Office: (0.48 × 1.02 + 0.44 × 1.077 + 0.01 × 1.21) × $33.4009 = $32.59
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
| 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
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.
How 97542 has changed in Connecticut
97542 · Office / nonfacility
$32.59
Effective 2026-10-01
The base rate is $0.10 higher than on 2025-10-01, moving from $32.49 to $32.59 (0.3%).
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
$32.49changed to$32.59
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.46 changed to 0.44
- Work GPCI 1.022 changed to 1.020
- Practice expense GPCI 1.091 changed to 1.077
- Malpractice GPCI 1.207 changed to 1.210
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$33.44changed to$32.49
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$32.89changed to$33.44
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$34.29changed to$32.89
- Conversion factor 33.8872 changed to 32.7442
- Work GPCI 1.030 changed to 1.022
- Practice expense GPCI 1.102 changed to 1.091
- Malpractice GPCI 1.070 changed to 1.207
January 1, 2023
RVU23A
$34.83changed to$34.29
- 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 1.037 changed to 1.030
- Practice expense GPCI 1.114 changed to 1.102
- Malpractice GPCI 0.934 changed to 1.070
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$35.12changed to$34.83
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$36.29changed to$35.12
- Conversion factor 36.0896 changed to 34.8931
- Work GPCI 1.029 changed to 1.037
- Practice expense GPCI 1.113 changed to 1.114
- Malpractice GPCI 1.094 changed to 0.934
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$36.20changed to$36.29
- Conversion factor 36.0391 changed to 36.0896
- Work GPCI 1.021 changed to 1.029
- Practice expense GPCI 1.112 changed to 1.113
- Malpractice GPCI 1.255 changed to 1.094
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$36.56changed to$36.20
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.45 changed to 0.44
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$33.45changed to$36.56
- Conversion factor 35.8887 changed to 35.9996
- Work RVU 0.45 changed to 0.48
- Practice expense RVU 0.40 changed to 0.45
- Work GPCI 1.023 changed to 1.021
- Practice expense GPCI 1.117 changed to 1.112
- Malpractice GPCI 1.244 changed to 1.255
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$33.44changed to$33.45
- Conversion factor 35.8043 changed to 35.8887
- Work GPCI 1.024 changed to 1.023
- Practice expense GPCI 1.121 changed to 1.117
- Malpractice GPCI 1.232 changed to 1.244
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$33.11changed to$33.44
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.01 changed to 0.02
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$32.95changed to$33.11
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$32.94changed to$32.95
- Conversion factor 35.8228 changed to 35.7547
- Practice expense GPCI 1.116 changed to 1.121
- Malpractice GPCI 1.234 changed to 1.232
Held through RVU15B.
January 1, 2014
RVU14A
$32.34changed to$32.94
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.43 changed to 0.40
- Practice expense GPCI 1.110 changed to 1.116
- Malpractice GPCI 1.235 changed to 1.234
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $32.34
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $32.59 | Not available in this setting | RVU26D |
| 2026-07-01 | $32.59 | Not available in this setting | RVU26C |
| 2026-04-01 | $32.59 | Not available in this setting | RVU26B |
| 2026-01-01 | $32.59 | Not available in this setting | RVU26A |
| 2025-10-01 | $32.49 | Not available in this setting | RVU25D |
| 2025-07-01 | $32.49 | Not available in this setting | RVU25C |
| 2025-04-01 | $32.49 | Not available in this setting | RVU25B |
| 2025-01-01 | $32.49 | Not available in this setting | RVU25A |
| 2024-10-01 | $33.44 | Not available in this setting | RVU24D |
| 2024-07-01 | $33.44 | Not available in this setting | RVU24C |
| 2024-04-01 | $33.44 | Not available in this setting | RVU24B |
| 2024-03-09 | $33.44 | Not available in this setting | RVU24AR |
| 2024-01-01 | $32.89 | Not available in this setting | RVU24A |
| 2023-10-01 | $34.29 | Not available in this setting | RVU23D |
| 2023-07-01 | $34.29 | Not available in this setting | RVU23C |
| 2023-04-01 | $34.29 | Not available in this setting | RVU23B |
| 2023-01-01 | $34.29 | Not available in this setting | RVU23A |
| 2022-10-01 | $34.83 | Not available in this setting | RVU22D |
| 2022-07-01 | $34.83 | Not available in this setting | RVU22C |
| 2022-04-01 | $34.83 | Not available in this setting | RVU22B |
| 2022-01-01 | $34.83 | Not available in this setting | RVU22A |
| 2021-10-01 | $35.12 | Not available in this setting | RVU21D |
| 2021-07-01 | $35.12 | Not available in this setting | RVU21C |
| 2021-04-01 | $35.12 | Not available in this setting | RVU21B |
| 2021-01-01 | $35.12 | Not available in this setting | RVU21A |
| 2020-10-01 | $36.29 | Not available in this setting | RVU20D |
| 2020-07-01 | $36.29 | Not available in this setting | RVU20C |
| 2020-04-01 | $36.29 | Not available in this setting | RVU20B |
| 2020-01-01 | $36.29 | Not available in this setting | RVU20A |
| 2019-10-01 | $36.20 | Not available in this setting | RVU19D |
| 2019-07-01 | $36.20 | Not available in this setting | RVU19C |
| 2019-04-01 | $36.20 | Not available in this setting | RVU19B |
| 2019-01-01 | $36.20 | Not available in this setting | RVU19A |
| 2018-10-01 | $36.56 | Not available in this setting | RVU18D |
| 2018-07-01 | $36.56 | Not available in this setting | RVU18C |
| 2018-04-01 | $36.56 | Not available in this setting | RVU18B |
| 2018-01-01 | $36.56 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $33.45 | Not available in this setting | RVU17D |
| 2017-07-01 | $33.45 | Not available in this setting | RVU17C |
| 2017-04-01 | $33.45 | Not available in this setting | RVU17B |
| 2017-01-01 | $33.45 | Not available in this setting | RVU17A |
| 2016-10-01 | $33.44 | Not available in this setting | RVU16D |
| 2016-07-01 | $33.44 | Not available in this setting | RVU16C |
| 2016-04-01 | $33.44 | Not available in this setting | RVU16B |
| 2016-01-01 | $33.44 | Not available in this setting | RVU16A |
| 2015-10-01 | $33.11 | Not available in this setting | RVU15D |
| 2015-07-01 | $33.11 | Not available in this setting | RVU15C |
| 2015-04-01 | $32.95 | Not available in this setting | RVU15B |
| 2015-01-01 | $32.95 | Not available in this setting | RVU15A |
| 2014-10-01 | $32.94 | Not available in this setting | RVU14D |
| 2014-07-01 | $32.94 | Not available in this setting | RVU14C |
| 2014-04-01 | $32.94 | Not available in this setting | RVU14B |
| 2014-01-01 | $32.94 | Not available in this setting | RVU14A |
| 2013-10-01 | $32.34 | Not available in this setting | RVU13D |
| 2013-07-01 | $32.34 | Not available in this setting | RVU13C |
| 2013-04-01 | $32.34 | Not available in this setting | RVU13B |
| 2013-01-01 | $32.34 | Not available in this setting | RVU13AR |
Where the Connecticut rate applies
Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.
- Ansonia
- Ball Pond
- Baltic
- Bantam
- Bethel
- Bethlehem Village
- Bigelow Corners
- Blue Hills
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
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