Billing code 97113: Aquatic therapyMedicare rate & RVUs in Georgia
Report aquatic therapeutic exercise for direct, one-on-one treatment in a pool when water supports strengthening, range of motion, balance, or mobility goals.
Medicare pays $34.90–$37.52 for 97113 in the office in Georgia, from Rest Of Georgia to Atlanta. 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.
On this page 9 sections
What 97113 covers
Aquatic therapy uses exercise in a pool, where buoyancy reduces joint loading and water provides resistance. Physical therapists, occupational therapists, and supervised therapy assistants provide it to patients who have difficulty tolerating land-based activity, including those recovering from joint replacement or managing osteoarthritis or neurologic weakness. Treatment may include water walking, resisted limb movements, balance drills, and flexibility exercises. The clinician provides direct one-on-one contact, whether working from the pool deck or in the water.
Report 97113 in 15-minute units based on direct treatment time, not the patient's total time in the pool. Documentation should identify the exercises, direct treatment minutes, and why the aquatic environment supports the plan of care. For Medicare, identify the therapy discipline with GP or GO, as appropriate, and determine units using the total timed therapy minutes furnished that day. This therapy service has no separate professional component for modifier 26. Under Medicare's therapy multiple procedure payment reduction, the practice expense portion is reduced for the second and later therapy units on the same day, including additional 97113 units.
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 97113 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $37.52 | Unavailable |
| Rest Of Georgia | $34.90 | Unavailable |
How the 97113 rate is calculated
Each of 97113’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 · 97113
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.48Practice expense 0.62Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 97113
The CMS indicators that decide how 97113 is paid alongside other services.
CMS payment indicators · 97113
Aquatic therapy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 5 | Therapy reduction: practice expense of the second and later units is reduced. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 7 | Therapy service: the split doesn’t apply. |
What modifiers do to the payment
Modifier CQ · payment effect
With and without the modifier
97113 without CQ · national office
$37.07
Aquatic therapy
97113-CQ · Allowed amount unchanged
$37.07
Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.
97113 compared with similar codes
Compare codes
97113 vs 97110 vs 97150 vs 97116 vs 97112: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 97110Therapeutic exercise
- Both are timed exercise codes. Use 97113 when exercise is performed in a pool using the properties of water; use 97110 for land-based therapeutic exercise.
- 97150Group therapy
- 97113 requires direct one-on-one contact and is reported in 15-minute units. Use untimed 97150 for group-directed therapy provided to two or more patients simultaneously.
- 97116Gait training
- 97116 covers distinct gait-training time, such as instruction in walking with an assistive device on land. Water walking performed as aquatic therapy is reported under 97113 for those minutes.
- 97112Neuromuscular reeducation
- 97112 covers distinct neuromuscular reeducation time, such as land-based balance training. Balance exercises performed as aquatic therapy are reported under 97113 for those minutes.
97113 billing questions
When should 97113 be reported instead of 97110?
Use 97113 when exercise is performed in a pool and the water is part of the therapeutic intervention. Use 97110 for land-based therapeutic exercise.
Can aquatic therapy be billed for a group class in the pool?
97113 requires direct one-on-one contact. For group-directed pool exercise provided to two or more patients simultaneously, report the untimed group therapy code 97150 instead.
How are units counted for 97113?
Count direct one-on-one treatment minutes. Under Medicare's 8-minute rule, 8 to 22 minutes supports one unit and 23 to 37 minutes supports two units when 97113 is the only timed therapy service; when multiple timed services are furnished, determine total units from their combined timed minutes and allocate units to the services performed.
Should gait or balance work done in the pool be coded separately as 97116 or 97112?
Water walking and balance exercises performed as part of aquatic therapy are included in 97113 for those minutes. Separate 97116 or 97112 units require distinct treatment time for the respective intervention.
What documentation supports medical necessity for aquatic rather than land therapy?
Document why the water environment supports treatment, such as pain or limited weight-bearing tolerance during land exercise. Record the exercises performed, direct treatment minutes, and their connection to the patient's goals.
Does the therapy reduction apply to every 97113 unit?
No. Medicare reduces the practice expense portion for second and later therapy units on the same day, including additional 97113 units; it does not reduce every unit solely because 97113 was reported.
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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