$36.98
97535 teaches specific ADL and home management skills; 97530 uses dynamic activities to improve functional performance. Select the code that matches the documented treatment.
On this page
CMS RVU26D · Effective 2026-10-01
97535 Self-care training Medicare reimbursement rates in Connecticut
Direct, one-on-one training in daily living and home management skills, such as dressing or meal preparation, reported as a timed therapy service. Compare 97535 office and facility rates across CMS payment localities in Connecticut.
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 97535 in Connecticut?
Connecticut 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
$34.08
1 of 1 localities have a supported rate.
Payment area: Connecticut
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.
Physical medicine and rehabilitation
About 97535: Self-care and home management training, each 15 minutes
Direct, one-on-one training in daily living and home management skills, such as dressing or meal preparation, reported as a timed therapy service.
This service involves direct, one-on-one instruction that helps a patient manage personal care and home tasks safely. Typical content includes training in dressing, bathing, toileting, grooming, feeding, kitchen safety, and meal preparation. Instruction may address compensatory techniques after a stroke or joint replacement, energy conservation, or use of adaptive equipment such as reachers, sock aids, and tub benches. Occupational therapists commonly provide this training; physical therapists may also provide it when appropriate to the treatment plan. Settings include private practices, outpatient therapy clinics, and hospital outpatient departments.
Report this timed code for documented patient-directed self-care or home management training. Record the tasks practiced, the patient's assistance needs, the instruction and cues provided, and direct treatment minutes. Medicare uses total timed therapy minutes to determine the day's allowable units; code-specific minutes support how those units are allocated. Identify the therapy plan of care with the appropriate discipline modifier. This therapy service has no professional component to report with modifier 26. Under the therapy multiple procedure payment reduction, practice expense is reduced for the second and later therapy units furnished on the same day.
CMS billing rules for 97535
- 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 RVU0.45 · 46%
- Practice expense (office) RVU0.51 · 53%
- Malpractice RVU0.01 · 1%
3.9M
Medicare services in 2024 · #48 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.
97535 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$33.66
97537 addresses community or workplace participation, such as using public transportation or practicing workplace routines. 97535 addresses personal care and home management tasks.
$32.59
Wheelchair propulsion and management training belongs to 97542. Teaching a patient to perform personal care tasks while seated in a wheelchair may instead support 97535.
$54.98
97550 describes qualifying caregiver training without the patient present, beginning with the first 30 minutes. 97535 is direct, one-on-one training of the patient in self-care or home management.
Compare 97535 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
Connecticut →
Office / nonfacility
$34.08
Facility
Unavailable
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Physical therapy
Compare selected outpatient therapy base rates before claim-level adjustments.
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 97535 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
12,891
- Code
- 97535
- Physician work
- 0.45
- Practice expense
- 0.51
- Malpractice
- 0.01
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.45 | × 1.020 | 0.4590 |
| Practice expense | 0.51 | × 1.077 | 0.5493 |
| Malpractice | 0.01 | × 1.210 | 0.0121 |
| Total RVUs | 1.0204 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$34.08
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.45 | 1.02 |
| Practice expense | 0.51 | 1.077 |
| Malpractice | 0.01 | 1.21 |
(0.45 × 1.02 + 0.51 × 1.077 + 0.01 × 1.21) × $33.4009 = $34.08
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.
97535 billing questions
How is this code different from 97530 therapeutic activities?
Use 97535 for instruction in a specific self-care or home task, such as dressing or using a tub bench. Use 97530 for dynamic activities, such as lifting or transfer practice, directed at improving functional performance rather than teaching that task.
Can time spent training a family member be counted?
Count only direct, one-on-one training furnished to the patient toward 97535. For qualifying training furnished to caregivers without the patient present, 97550 describes the first 30 minutes; 97551 covers additional 15-minute increments.
Which therapy modifier identifies the plan of care?
Use GO for an occupational therapy plan of care or GP for a physical therapy plan of care. Use GN if the service is furnished under a speech-language pathology plan of care.
How many units can be billed for a session?
Medicare determines the day's allowable timed therapy units from total direct timed therapy minutes. Document the actual minutes of 97535 separately so the units can be allocated to the services furnished.
Is instruction in adaptive equipment use reported here?
Yes, patient training in equipment used for daily living, such as a reacher or tub bench, can be reported with 97535. Use 97542 for wheelchair management training and 97760 for orthotic management and 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 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.
12,88897172,,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
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
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808