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CMS RVU26D · Effective 2026-10-01

97542 in Delaware

Office / nonfacility

$30.93

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Rehabilitation therapy

About 97542: Wheelchair assessment and use training

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

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.

CMS billing rules for 97542

Professional and technical components
Therapy service: the professional component modifier does not apply.
Multiple procedures
Therapy multiple procedure payment reduction: practice expense is reduced for the second and later therapy units on the same day.

Where the value comes from

  • Work RVU0.48 · 52%
  • Practice expense (office) RVU0.44 · 47%
  • Malpractice RVU0.01 · 1%

130K

Medicare services in 2024 · #489 by national volume

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.

97542 compared with similar codes

Office rates for Delaware, from the same CMS release.

97535

Self-care training

ADL and home management, per 15 minutes

$32.24

Choose 97542 for wheelchair assessment, fitting, and use instruction. Choose 97535 when the skilled intervention trains self-care or daily living tasks.

97530

Therapeutic activities

One-on-one, each 15 minutes

$34.87

97530 covers dynamic therapeutic activities; 97542 is specific to wheelchair assessment, fitting, or use training.

97537

Reintegration training

Community or work skills

$31.92

97537 focuses on community or work reintegration activities. Use 97542 for wheelchair-specific assessment, fitting, and instruction.

The same code, a different location

How does Delaware compare?

97542 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $30.93

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $34.30

    $3.37 higher than Delaware

  3. Dc + Md/Va Suburbs

    $34.58

    $3.65 higher than Delaware

  4. Miami

    $32.18

    $1.25 higher than Delaware

  5. Chicago

    $31.68

    $0.75 higher than Delaware

  6. Manhattan

    $34.67

    $3.74 higher than Delaware

  7. Alaska*

    $39.88

    $8.95 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 97542 ranges from $28.83 in Arkansas to $39.88 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 97542

    Office

    $29.08

    Facility

    Unavailable

    $1.85 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 97542

    Office

    $28.83

    Facility

    Unavailable

    $2.10 lower than Delaware for the office setting.

  • Arizona

    Arizona · 97542

    Office

    $30.56

    Facility

    Unavailable

    $0.37 lower than Delaware for the office setting.

  • Bakersfield

    California · 97542

    Office

    $32.65

    Facility

    Unavailable

    $1.72 higher than Delaware for the office setting.

  • Chico

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • El Centro

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Fresno

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Madera

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Merced

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Modesto

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Napa

    California · 97542

    Office

    $36.58

    Facility

    Unavailable

    $5.65 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 97542

    Office

    $34.06

    Facility

    Unavailable

    $3.13 higher than Delaware for the office setting.

  • Redding

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Rest Of California

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 97542

    Office

    $32.71

    Facility

    Unavailable

    $1.78 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 97542

    Office

    $33.88

    Facility

    Unavailable

    $2.95 higher than Delaware for the office setting.

  • Salinas

    California · 97542

    Office

    $33.74

    Facility

    Unavailable

    $2.81 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 97542

    Office

    $34.27

    Facility

    Unavailable

    $3.34 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 97542

    Office

    $38.43

    Facility

    Unavailable

    $7.50 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 97542

    Office

    $38.42

    Facility

    Unavailable

    $7.49 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 97542

    Office

    $39.17

    Facility

    Unavailable

    $8.24 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 97542

    Office

    $39.12

    Facility

    Unavailable

    $8.19 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 97542

    Office

    $33.22

    Facility

    Unavailable

    $2.29 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 97542

    Office

    $34.40

    Facility

    Unavailable

    $3.47 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 97542

    Office

    $33.80

    Facility

    Unavailable

    $2.87 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 97542

    Office

    $34.74

    Facility

    Unavailable

    $3.81 higher than Delaware for the office setting.

  • Stockton

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Vallejo

    California · 97542

    Office

    $36.57

    Facility

    Unavailable

    $5.64 higher than Delaware for the office setting.

  • Visalia

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Yuba City

    California · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Colorado

    Colorado · 97542

    Office

    $32.12

    Facility

    Unavailable

    $1.19 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 97542

    Office

    $32.59

    Facility

    Unavailable

    $1.66 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 97542

    Office

    $31.52

    Facility

    Unavailable

    $0.59 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 97542

    Office

    $30.58

    Facility

    Unavailable

    $0.35 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 97542

    Office

    $31.41

    Facility

    Unavailable

    $0.48 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 97542

    Office

    $29.54

    Facility

    Unavailable

    $1.39 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 97542

    Office

    $32.94

    Facility

    Unavailable

    $2.01 higher than Delaware for the office setting.

  • Iowa

    Iowa · 97542

    Office

    $29.61

    Facility

    Unavailable

    $1.32 lower than Delaware for the office setting.

  • Idaho

    Idaho · 97542

    Office

    $29.71

    Facility

    Unavailable

    $1.22 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 97542

    Office

    $30.23

    Facility

    Unavailable

    $0.70 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 97542

    Office

    $29.97

    Facility

    Unavailable

    $0.96 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 97542

    Office

    $31.83

    Facility

    Unavailable

    $0.90 higher than Delaware for the office setting.

  • Indiana

    Indiana · 97542

    Office

    $29.82

    Facility

    Unavailable

    $1.11 lower than Delaware for the office setting.

  • Kansas

    Kansas · 97542

    Office

    $29.49

    Facility

    Unavailable

    $1.44 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 97542

    Office

    $29.40

    Facility

    Unavailable

    $1.53 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 97542

    Office

    $30.24

    Facility

    Unavailable

    $0.69 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 97542

    Office

    $29.36

    Facility

    Unavailable

    $1.57 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 97542

    Office

    $34.53

    Facility

    Unavailable

    $3.60 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 97542

    Office

    $32.03

    Facility

    Unavailable

    $1.10 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 97542

    Office

    $32.47

    Facility

    Unavailable

    $1.54 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 97542

    Office

    $31.37

    Facility

    Unavailable

    $0.44 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 97542

    Office

    $29.76

    Facility

    Unavailable

    $1.17 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 97542

    Office

    $30.81

    Facility

    Unavailable

    $0.12 lower than Delaware for the office setting.

  • Detroit

    Michigan · 97542

    Office

    $30.78

    Facility

    Unavailable

    $0.15 lower than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 97542

    Office

    $29.83

    Facility

    Unavailable

    $1.10 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 97542

    Office

    $31.25

    Facility

    Unavailable

    $0.32 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 97542

    Office

    $30.16

    Facility

    Unavailable

    $0.77 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 97542

    Office

    $30.36

    Facility

    Unavailable

    $0.57 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 97542

    Office

    $29.03

    Facility

    Unavailable

    $1.90 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 97542

    Office

    $28.93

    Facility

    Unavailable

    $2.00 lower than Delaware for the office setting.

  • Montana**

    Montana · 97542

    Office

    $31.06

    Facility

    Unavailable

    $0.13 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 97542

    Office

    $29.96

    Facility

    Unavailable

    $0.97 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 97542

    Office

    $30.86

    Facility

    Unavailable

    $0.07 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 97542

    Office

    $29.72

    Facility

    Unavailable

    $1.21 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 97542

    Office

    $31.62

    Facility

    Unavailable

    $0.69 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 97542

    Office

    $34.45

    Facility

    Unavailable

    $3.52 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 97542

    Office

    $33.09

    Facility

    Unavailable

    $2.16 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 97542

    Office

    $29.91

    Facility

    Unavailable

    $1.02 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 97542

    Office

    $31.02

    Facility

    Unavailable

    $0.09 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 97542

    Office

    $35.15

    Facility

    Unavailable

    $4.22 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 97542

    Office

    $33.25

    Facility

    Unavailable

    $2.32 higher than Delaware for the office setting.

  • Queens

    New York · 97542

    Office

    $34.91

    Facility

    Unavailable

    $3.98 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 97542

    Office

    $30.23

    Facility

    Unavailable

    $0.70 lower than Delaware for the office setting.

  • Ohio

    Ohio · 97542

    Office

    $29.79

    Facility

    Unavailable

    $1.14 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 97542

    Office

    $29.42

    Facility

    Unavailable

    $1.51 lower than Delaware for the office setting.

  • Portland

    Oregon · 97542

    Office

    $32.87

    Facility

    Unavailable

    $1.94 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 97542

    Office

    $30.90

    Facility

    Unavailable

    $0.03 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 97542

    Office

    $32.02

    Facility

    Unavailable

    $1.09 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 97542

    Office

    $29.84

    Facility

    Unavailable

    $1.09 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 97542

    Office

    $31.22

    Facility

    Unavailable

    $0.29 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 97542

    Office

    $31.82

    Facility

    Unavailable

    $0.89 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 97542

    Office

    $29.90

    Facility

    Unavailable

    $1.03 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 97542

    Office

    $30.84

    Facility

    Unavailable

    $0.09 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 97542

    Office

    $29.57

    Facility

    Unavailable

    $1.36 lower than Delaware for the office setting.

  • Austin

    Texas · 97542

    Office

    $31.91

    Facility

    Unavailable

    $0.98 higher than Delaware for the office setting.

  • Beaumont

    Texas · 97542

    Office

    $29.72

    Facility

    Unavailable

    $1.21 lower than Delaware for the office setting.

  • Brazoria

    Texas · 97542

    Office

    $30.99

    Facility

    Unavailable

    $0.06 higher than Delaware for the office setting.

  • Dallas

    Texas · 97542

    Office

    $31.10

    Facility

    Unavailable

    $0.17 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 97542

    Office

    $30.96

    Facility

    Unavailable

    $0.03 higher than Delaware for the office setting.

  • Galveston

    Texas · 97542

    Office

    $31.03

    Facility

    Unavailable

    $0.10 higher than Delaware for the office setting.

  • Houston

    Texas · 97542

    Office

    $31.21

    Facility

    Unavailable

    $0.28 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 97542

    Office

    $30.28

    Facility

    Unavailable

    $0.65 lower than Delaware for the office setting.

  • Utah

    Utah · 97542

    Office

    $30.15

    Facility

    Unavailable

    $0.78 lower than Delaware for the office setting.

  • Virginia

    Virginia · 97542

    Office

    $30.71

    Facility

    Unavailable

    $0.22 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 97542

    Office

    $31.22

    Facility

    Unavailable

    $0.29 higher than Delaware for the office setting.

  • Vermont

    Vermont · 97542

    Office

    $30.75

    Facility

    Unavailable

    $0.18 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 97542

    Office

    $31.97

    Facility

    Unavailable

    $1.04 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 97542

    Office

    $35.14

    Facility

    Unavailable

    $4.21 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 97542

    Office

    $30.21

    Facility

    Unavailable

    $0.72 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 97542

    Office

    $29.28

    Facility

    Unavailable

    $1.65 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 97542

    Office

    $30.98

    Facility

    Unavailable

    $0.05 higher than Delaware for the office setting.

See how rates vary across the country

97542 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 all state and territory rates as a table
State / territoryRate 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

Explore 97542 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 97542 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$34.02

$30.93 × 110% = $34.02

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 97542 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

12,893

Code
97542
Physician work
0.48
Practice expense
0.44
Malpractice
0.01

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 97542 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.48× 1.0050.4824
Practice expense0.44× 0.9880.4347
Malpractice0.01× 0.8990.0090
Total RVUs0.9261
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$30.93

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 97542 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.481.005
Practice expense0.440.988
Malpractice0.010.899

(0.48 × 1.005 + 0.44 × 0.988 + 0.01 × 0.899) × $33.4009 = $30.93

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

97542 · Office / nonfacility

$30.93

Effective 2026-10-01

The base rate is $0.20 higher than on 2025-10-01, moving from $30.73 to $30.93 (0.7%).

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

    $30.73changed to$30.93

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.46 changed to 0.44
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $30.73

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$30.93Not available in this settingRVU26D
2026-07-01$30.93Not available in this settingRVU26C
2026-04-01$30.93Not available in this settingRVU26B
2026-01-01$30.93Not available in this settingRVU26A
2025-10-01$30.73Not available in this settingRVU25D
2025-07-01$30.73Not available in this settingRVU25C
2025-04-01$30.73Not available in this settingRVU25B
2025-01-01$30.73Not available in this settingRVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 97542PPRRVU2026_Oct_nonQPP.csv, line 12,893 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet