$30.12
Choose 97542 for wheelchair assessment, fitting, and use instruction. Choose 97535 when the skilled intervention trains self-care or daily living tasks.
On this page
CMS RVU26D · Effective 2026-10-01
97542 Wheelchair training Medicare reimbursement rates in Alabama
A therapist assesses wheelchair needs, fits or adjusts the chair, and trains the patient to use it safely and effectively. Compare 97542 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 97542 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$29.08
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
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 Alabama, from the same CMS release.
$32.42
97530 covers dynamic therapeutic activities; 97542 is specific to wheelchair assessment, fitting, or use training.
$29.96
97537 focuses on community or work reintegration activities. Use 97542 for wheelchair-specific assessment, fitting, and instruction.
Compare 97542 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$29.08
Facility
Unavailable
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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 Alabama.
PPRRVU2026_Oct_nonQPP.csv
12,893
- Code
- 97542
- Physician work
- 0.48
- Practice expense
- 0.44
- Malpractice
- 0.01
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.48 | × 1.000 | 0.4800 |
| Practice expense | 0.44 | × 0.875 | 0.3850 |
| Malpractice | 0.01 | × 0.566 | 0.0057 |
| Total RVUs | 0.8707 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$29.08
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.48 | 1 |
| Practice expense | 0.44 | 0.875 |
| Malpractice | 0.01 | 0.566 |
(0.48 × 1 + 0.44 × 0.875 + 0.01 × 0.566) × $33.4009 = $29.08
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.
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.
12,89097533,,Sensory integration,A,,0.48,1.33,,1.33,NA,0.01,1.82,1.82,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89197535,,Self care mngment training,A,,0.45,0.51,,0.51,NA,0.01,0.97,0.97,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89297537,,Community/work reintegration,A,,0.48,0.47,,0.47,NA,0.01,0.96,0.96,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89397542,,Wheelchair mngment training,A,,0.48,0.44,,0.44,NA,0.01,0.93,0.93,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89497545,,Work hardening,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,7,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89597546,,Work hardening add-on,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,7,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89697550,,Caregiver traing 1st 30 min,A,,1.00,0.57,,0.18,,0.01,1.58,1.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515