CPT code 97552: Caregiver training, group, per 15 minutes2026 Medicare rate & RVUs in Illinois
Reports face-to-face group instruction for two or more caregivers when a patient’s condition requires caregiver support for function at home or in the community.
Medicare pays $21.01–$22.73 for 97552 in the office in Illinois, from Rest of Illinois to Suburban Chicago, IL. 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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What 97552 covers
A qualified health professional trains two or more caregivers together in strategies that support a patient’s functional performance at home or in the community. Instruction may address practical caregiving tasks such as mobility, transfers, daily activities, communication, feeding, problem-solving, or safety. The patient is not present during the training. The service is distinct from treating the patient directly or giving one caregiver individual instruction.
Report this code for each 15 minutes of qualifying group training. Documentation should identify the caregivers, the patient’s need for caregiver assistance, the skilled strategies taught, and the face-to-face training time. CMS assigns the service work and practice-expense values, with separate practice-expense inputs for office and facility settings. The code is part of the caregiver-training family; individual caregiver instruction is reported with the corresponding individual-training codes.
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 97552 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$21.01 to $22.73
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $22.60 | $9.85 |
| East St. Louis, IL | $21.26 | $9.58 |
| Rest of Illinois | $21.01 | $9.42 |
| Suburban Chicago, IL | $22.73 | $9.70 |
How the 97552 rate is calculated
Each of 97552’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 · 97552
RVUs × geographic indexes × conversion factor
Work0.23
0.23 RVUs× 1.000 GPCI
Practice expense0.42
0.42 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.6600
Conversion factor
$33.4009
Medicare rate
$22.04
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97552
97552 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 97552
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$22.04
- Non-facility (office)
- $22.04
- Facility
- $9.35
Higher because the practice carries its own overhead.
97552 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 97550Caregiver trainingInitial 30 minutes
- 97550 is for individual caregiver training, while 97552 is for training two or more caregivers together.
- 97551Caregiver trainingEach additional 15 minutes
- 97551 reports additional individual caregiver-training time with 97550; it is not the group-training code.
- 97535Self-care trainingADL and home management, per 15 minutes
- 97535 covers self-care or home-management training directed to the patient. 97552 covers caregiver instruction with the patient absent.
97552 billing questions
When should this code be used instead of 97550?
Use 97552 when two or more caregivers receive the training together. Code 97550 describes individual caregiver training.
Does the patient attend the group training?
No. This caregiver-training service is performed face-to-face with the caregivers while the patient is absent.
How are units reported?
Report one unit for each 15 minutes of qualifying group training, supported by documentation of the face-to-face training time.
Can this be reported for teaching the patient directly?
No. The service is for caregiver instruction without the patient present. Direct self-care or home-management training for the patient is represented by 97535 when its requirements are met.
What documentation supports the service?
Document why the patient needs caregiver assistance, who attended, the functional strategies taught, and the time spent in face-to-face group instruction.
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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