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

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

CMS RVU26DEffective Oct 1, 2026One payment locality130K Medicare services in 2024

In South Dakota, Medicare pays $30.84 for 97542 in the office.

$30.84Office (non-facility)
Not available in this settingHospital or facility
−0.7%vs the national office rate ($31.06)

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.

We’ll open 97542 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 97542 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How South Dakota 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. South Dakota pays $30.84. The RVUs are the same everywhere; the geographic indexes change the dollars.

97542 in South Dakota vs other payment areas
  1. South Dakota · this page$30.84
  2. Los Angeles, CA · California$34.30+$3.46
  3. Washington, DC area · District of Columbia$34.58+$3.74
  4. Miami, FL · Florida$32.18+$1.34
  5. Chicago, IL · Illinois$31.68+$0.84
  6. Manhattan, NY · New York$34.67+$3.83
  7. Alaska · Alaska$39.88+$9.04

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

Every other payment area

97542 in every other Medicare payment locality
Payment localityOfficeFacility
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—

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
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

See 97542 in every payment locality

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.

The exact South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 97542 in South Dakota
ComponentRVULocality factorAdjusted
Physician work0.48× 1.0000.4800
Practice expense0.44× 1.0000.4400
Malpractice0.01× 0.3360.0034
Total RVUs0.9234
Conversion factor× 33.4009

Office rate, South Dakota$30.84

Office: (0.48 × 1 + 0.44 × 1 + 0.01 × 0.336) × $33.4009 = $30.84

Open 97542 in the RVU calculator

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.

How 97542 has changed in South Dakota

97542 · Office / nonfacility

$30.84

Effective 2026-10-01

The base rate is $0.31 higher than on 2025-10-01, moving from $30.53 to $30.84 (1.0%).

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

    $30.53changed to$30.84

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.46 changed to 0.44
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $31.42changed to$30.53

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $30.90changed to$31.42

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $31.98changed to$30.90

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

    RVU23A

    $32.08changed to$31.98

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $32.34changed to$32.08

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $33.47changed to$32.34

    • 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

    $33.44changed to$33.47

    • 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

    $33.76changed to$33.44

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.45 changed to 0.44

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $30.79changed to$33.76

    • 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
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $30.72changed to$30.79

    • 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

    $30.69changed to$30.72

    • 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

    $30.53changed to$30.69

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $30.60changed to$30.53

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

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $30.09changed to$30.60

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.43 changed to 0.40
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $30.09

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$30.84Not available in this settingRVU26D
2026-07-01$30.84Not available in this settingRVU26C
2026-04-01$30.84Not available in this settingRVU26B
2026-01-01$30.84Not available in this settingRVU26A
2025-10-01$30.53Not available in this settingRVU25D
2025-07-01$30.53Not available in this settingRVU25C
2025-04-01$30.53Not available in this settingRVU25B
2025-01-01$30.53Not available in this settingRVU25A
2024-10-01$31.42Not available in this settingRVU24D
2024-07-01$31.42Not available in this settingRVU24C
2024-04-01$31.42Not available in this settingRVU24B
2024-03-09$31.42Not available in this settingRVU24AR
2024-01-01$30.90Not available in this settingRVU24A
2023-10-01$31.98Not available in this settingRVU23D
2023-07-01$31.98Not available in this settingRVU23C
2023-04-01$31.98Not available in this settingRVU23B
2023-01-01$31.98Not available in this settingRVU23A
2022-10-01$32.08Not available in this settingRVU22D
2022-07-01$32.08Not available in this settingRVU22C
2022-04-01$32.08Not available in this settingRVU22B
2022-01-01$32.08Not available in this settingRVU22A
2021-10-01$32.34Not available in this settingRVU21D
2021-07-01$32.34Not available in this settingRVU21C
2021-04-01$32.34Not available in this settingRVU21B
2021-01-01$32.34Not available in this settingRVU21A
2020-10-01$33.47Not available in this settingRVU20D
2020-07-01$33.47Not available in this settingRVU20C
2020-04-01$33.47Not available in this settingRVU20B
2020-01-01$33.47Not available in this settingRVU20A
2019-10-01$33.44Not available in this settingRVU19D
2019-07-01$33.44Not available in this settingRVU19C
2019-04-01$33.44Not available in this settingRVU19B
2019-01-01$33.44Not available in this settingRVU19A
2018-10-01$33.76Not available in this settingRVU18D
2018-07-01$33.76Not available in this settingRVU18C
2018-04-01$33.76Not available in this settingRVU18B
2018-01-01$33.76Not available in this settingRVU18AR1
2017-10-01$30.79Not available in this settingRVU17D
2017-07-01$30.79Not available in this settingRVU17C
2017-04-01$30.79Not available in this settingRVU17B
2017-01-01$30.79Not available in this settingRVU17A
2016-10-01$30.72Not available in this settingRVU16D
2016-07-01$30.72Not available in this settingRVU16C
2016-04-01$30.72Not available in this settingRVU16B
2016-01-01$30.72Not available in this settingRVU16A
2015-10-01$30.69Not available in this settingRVU15D
2015-07-01$30.69Not available in this settingRVU15C
2015-04-01$30.53Not available in this settingRVU15B
2015-01-01$30.53Not available in this settingRVU15A
2014-10-01$30.60Not available in this settingRVU14D
2014-07-01$30.60Not available in this settingRVU14C
2014-04-01$30.60Not available in this settingRVU14B
2014-01-01$30.60Not available in this settingRVU14A
2013-10-01$30.09Not available in this settingRVU13D
2013-07-01$30.09Not available in this settingRVU13C
2013-04-01$30.09Not available in this settingRVU13B
2013-01-01$30.09Not available in this settingRVU13AR

Price 97542 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

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

Open CMS sourceHow we calculate rates

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