CPT code 97551: Caregiver training, each additional 15 minutes2026 Medicare rate & RVUs in Maryland
Report this add-on for each additional 15 minutes of individual caregiver training after the initial caregiver training service for functional performance.
Medicare pays $26.33–$28.45 for 97551 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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 97551 covers
A qualified health professional provides face-to-face instruction to a patient's caregiver, without the patient present, on strategies and techniques that support the patient's functional performance at home or in the community. Training may address how to assist with daily activities or carry out techniques needed to support the patient's function. It is used in rehabilitation care when the caregiver needs additional instruction beyond the initial training service.
Report 97551 only with the primary caregiver-training service, 97550, for each additional 15 minutes beyond its initial training. Document the caregiver training provided, its connection to the patient's functional goals, and the time spent supporting the additional units. CMS classifies 97551 as an add-on code: it is billed only with a primary procedure, and payment is handled within that procedure's global period.
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 97551 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$26.33 to $28.45
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $26.93 | $21.55 |
| Rest of Maryland | $26.33 | $21.26 |
| Washington, DC area | $28.45 | $22.55 |
How the 97551 rate is calculated
Each of 97551’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 · 97551
RVUs × geographic indexes × conversion factor
Work0.54
0.54 RVUs× 1.000 GPCI
Practice expense0.24
0.24 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.7800
Conversion factor
$33.4009
Medicare rate
$26.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97551
The CMS indicators that decide how 97551 is paid alongside other services.
CMS payment indicators · 97551
Caregiver training, each additional 15 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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 | 0 | Physician service: no professional/technical split. |
97551 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 97550Caregiver trainingInitial 30 minutes
- 97550 covers the initial 30 minutes of individual caregiver training; 97551 covers each additional 15 minutes and must be paired with 97550.
- 97552Caregiver trainingGroup, per 15 minutes
- 97552 is for group caregiver training. 97551 adds time to individual caregiver training reported with 97550.
- 97535Self-care trainingADL and home management, per 15 minutes
- 97535 covers self-care management training for the patient. 97551 is for additional individual training provided to the caregiver without the patient present.
97551 billing questions
When should 97551 be used instead of 97550?
Use 97550 for the initial 30 minutes of individual caregiver training. Report 97551 for each additional 15 minutes of that training.
Can 97551 be billed by itself?
No. It is an add-on code and must be reported with the primary caregiver-training service, 97550.
Does the patient need to be present?
No. This caregiver-training service is provided face-to-face with the caregiver without the patient present.
How should the additional units be supported?
Document the caregiver instruction, the functional goal it supports, and the additional training time. The code represents each additional 15 minutes.
How does 97551 differ from group caregiver training?
97551 adds time to individual caregiver training reported with 97550. Use 97552 for group caregiver training.
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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