$37.09–$45.39
Choose 97533 for treatment directed at sensory processing and adaptive responses. Choose 97530 for skilled practice of functional activities and tasks.
On this page
CMS RVU26D · Effective 2026-10-01
97533 Sensory integration Medicare reimbursement rates in California
Reports one-on-one sensory integration treatment that addresses sensory processing and adaptive responses to environmental demands, billed in 15-minute units. Compare 97533 office and facility rates across CMS payment localities in California.
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 97533 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$65.17–$82.03
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $16.86 per service.
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.
Where 97533 pays more and less in California
29 payment localities
$65.17 to $82.03
Rehabilitation therapy
About 97533: Sensory integration treatment
Reports one-on-one sensory integration treatment that addresses sensory processing and adaptive responses to environmental demands, billed in 15-minute units.
An occupational therapist typically uses structured sensory experiences to help a patient process input and respond more effectively to everyday demands. Treatment may involve tactile, movement, or deep-pressure activities selected to address the patient’s functional needs, such as tolerating sensory input during dressing, play, or daily routines. This service is commonly provided in outpatient therapy settings, including pediatric practices, when skilled intervention is directed at sensory processing and adaptive responses rather than general exercise or task practice.
Report the service in 15-minute units for documented, direct one-on-one treatment. The record should identify the sensory techniques used, the patient’s response, and how the intervention addressed functional goals. This is a therapy service, so a professional-component modifier does not apply. Under the CMS therapy multiple procedure payment reduction, practice expense is reduced for the second and each later therapy unit furnished on the same day.
CMS billing rules for 97533
- 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 · 26%
- Practice expense (office) RVU1.33 · 73%
- Malpractice RVU0.01 · 1%
105K
Medicare services in 2024 · #541 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.
97533 compared with similar codes
Office rates for California, from the same CMS release.
$34.13–$41.43
97535 describes training in self-care and daily living skills. It is not the sensory-processing intervention described by 97533.
$34.37–$41.35
97112 focuses on neuromuscular reeducation, such as movement, balance, coordination, or posture training. Use 97533 when the intervention specifically targets sensory processing and adaptive responses.
Compare 97533 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $65.23 | Facility Unavailable |
| Chico | Office $65.17 | Facility Unavailable |
| El Centro | Office $65.17 | Facility Unavailable |
| Fresno | Office $65.17 | Facility Unavailable |
| Hanford-Corcoran | Office $65.17 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $69.46 | Facility Unavailable |
| Madera | Office $65.17 | Facility Unavailable |
| Merced | Office $65.17 | Facility Unavailable |
| Modesto | Office $65.17 | Facility Unavailable |
| Napa | Office $75.76 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $69.20 | Facility Unavailable |
| Redding | Office $65.17 | Facility Unavailable |
| Rest Of California | Office $65.17 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $65.29 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $68.45 | Facility Unavailable |
| Salinas | Office $68.19 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $69.82 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $80.35 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $80.33 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $82.03 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $81.99 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $67.08 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $70.52 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $68.46 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $71.24 | Facility Unavailable |
| Stockton | Office $65.17 | Facility Unavailable |
| Vallejo | Office $75.75 | Facility Unavailable |
| Visalia | Office $65.17 | Facility Unavailable |
| Yuba City | Office $65.17 | Facility Unavailable |
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97533 billing questions
How is this different from therapeutic activities?
Use 97533 when the intervention specifically targets sensory processing and adaptive responses to sensory input. Use 97530 when the skilled treatment is functional task or activity practice.
What should the treatment note describe?
Document the sensory techniques, direct treatment time, patient response, and connection to functional goals. The note should make clear why skilled sensory integration treatment was provided.
Is a professional-component modifier reported?
No. CMS identifies this as a therapy service for which a professional-component modifier does not apply.
How does the therapy multiple procedure reduction affect units?
CMS reduces practice expense for the second and each later therapy unit furnished on the same day. This applies when multiple therapy units are reported that day.
Can 97533 be reported with self-care training?
They may be reported for distinct skilled services when both sensory integration and self-care training are furnished. Keep the documented treatment time and intervention focus separate.
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.
12,88797171,,Athletic trn eval high cmplx,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,88897172,,Athletic trn re-eval plan cr,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
12,88997530,,Therapeutic activities,A,,0.44,0.60,,0.60,NA,0.01,1.05,1.05,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89097533,,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