CPT code 97545: Work hardening, initial two hours2026 Medicare rate & RVUs in Michigan
Reports the initial two-hour block of structured work hardening for a patient building the strength, endurance, and task skills needed for work.
Medicare pays $0.00 for 97545 in the office in Michigan (Detroit, MI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 97545 covers
Work hardening is a structured, job-focused rehabilitation program that builds a patient's capacity to return to work through progressively demanding physical tasks. Physical or occupational therapists commonly provide it in an outpatient rehabilitation setting. Activities may simulate job demands such as lifting, carrying, reaching, or sustained standing, with the program tailored to the patient's functional limitations and work goals. It is distinct from general exercise or isolated practice of daily activities because the treatment is organized around work capacity.
Report 97545 for the initial two-hour block; report 97546 for each additional hour when the service continues beyond that block. Documentation should support the treatment time, work-related functional goals, activities performed, patient response, and progress toward those goals. CMS lists payment as restricted to specific circumstances, so coverage depends on the applicable Medicare coverage criteria. This is a therapy service; the professional component modifier does not apply.
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 97545 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $0.00 | $0.00 |
| Rest of Michigan | $0.00 | $0.00 |
How the 97545 rate is calculated
Each of 97545’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 · 97545
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97545
The CMS indicators that decide how 97545 is paid alongside other services.
CMS payment indicators · 97545
Work hardening, initial two hours
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
97545 without CQ · national office
$0.00
Work hardening, initial two hours
97545-CQ · Allowed amount unchanged
$0.00
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.
97545 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 97546Work hardeningEach additional hour
- 97545 is the initial two-hour work-hardening block. 97546 reports each additional hour after that block.
- 97537Reintegration trainingCommunity or work skills
- 97537 focuses on community or work reintegration activities. Choose 97545 for structured, progressive conditioning directed at work capacity.
- 97530Therapeutic activitiesOne-on-one, each 15 minutes
- 97530 covers functional therapeutic activities. 97545 is specific to a work-hardening program with work-related capacity goals.
97545 billing questions
When should 97545 be used instead of 97530?
Use 97545 for a structured work-hardening program directed at improving work capacity. Use 97530 when the session centers on functional therapeutic activities without that work-hardening program focus.
How does 97546 pair with 97545?
97545 covers the initial two-hour block. Report 97546 for each additional hour of work hardening beyond that block.
What documentation supports 97545?
Document the time spent, work-related functional goals, job-focused tasks performed, the patient's response, and progress toward the goals.
Can modifier 26 be reported with 97545?
No. CMS identifies 97545 as a therapy service for which the professional component modifier does not apply.
Does Medicare pay 97545 for every work-hardening service?
No. CMS classifies payment as restricted to specific circumstances; the service must meet the applicable Medicare coverage criteria.
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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