$22.97
97129 reports the initial timed portion of cognitive function intervention. Use 97130 only for additional treatment time and only with 97129.
On this page
CMS RVU26D · Effective 2026-10-01
97130 Cognitive intervention Medicare reimbursement rates in Guam
Reports additional one-on-one cognitive function treatment addressing skills such as attention, memory, reasoning, and executive function after the initial timed service. Compare 97130 office and facility rates across CMS payment localities in Guam.
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 97130 in Guam?
Guam 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
$21.73
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$18.69
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
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 97130: Additional cognitive function intervention
Reports additional one-on-one cognitive function treatment addressing skills such as attention, memory, reasoning, and executive function after the initial timed service.
A therapist or other qualified health care professional uses skilled, direct one-on-one treatment to address cognitive functions that affect daily activities. Targets may include attention, memory, reasoning, executive function, problem solving, or pragmatic functioning. Treatment can also teach compensatory approaches, such as using a schedule or organizing and sequencing a task. It is commonly provided in outpatient rehabilitation for people with cognitive changes following stroke, brain injury, or neurologic disease.
Report 97130 only as an add-on to 97129, the primary code for the initial timed portion of this intervention. Each unit represents an additional 15 minutes of treatment; documentation should identify the cognitive goals, skilled interventions, direct patient contact, and time supporting the added service. CMS treats this as an add-on paid within the primary procedure’s global period. Do not use the same treatment minutes to support another timed service.
CMS billing rules for 97130
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.48 · 76%
- Practice expense (office) RVU0.15 · 24%
- Malpractice RVU0.00 · 0%
592.3K
Medicare services in 2024 · #207 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.
97130 compared with similar codes
Office rates for Guam, from the same CMS release.
$34.74
97130 focuses on cognitive skills and compensatory strategies; 97112 focuses on neuromuscular reeducation, such as movement or balance control.
$34.59
Use 97535 when the skilled service is self-care or home management training. Use 97130 when the treatment focus is cognitive function intervention.
Compare 97130 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
Hawaii, Guam →
Office / nonfacility
$21.73
Facility
$18.69
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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 97130 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
12,865
- Code
- 97130
- Physician work
- 0.48
- Practice expense
- 0.15
- Malpractice
- 0.00
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.48 | × 1.000 | 0.4800 |
| Practice expense | 0.15 | × 1.137 | 0.1706 |
| Malpractice | 0.00 | × 0.579 | 0.0000 |
| Total RVUs | 0.6505 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$21.73
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.48 | 1 |
| Practice expense | 0.15 | 1.137 |
| Malpractice | 0 | 0.579 |
(0.48 × 1 + 0.15 × 1.137 + 0 × 0.579) × $33.4009 = $21.73
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.48 | 1 |
| Practice expense | 0.07 | 1.137 |
| Malpractice | 0 | 0.579 |
(0.48 × 1 + 0.07 × 1.137 + 0 × 0.579) × $33.4009 = $18.69
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.
97130 billing questions
Can 97130 be reported by itself?
No. It is an add-on code and must be reported with 97129 for the initial portion of the cognitive function intervention.
What treatment supports reporting 97130?
Skilled, direct one-on-one work on cognitive functions such as attention, memory, reasoning, executive function, or problem solving, including compensatory strategies tied to activity performance.
How much time does one unit represent?
One unit represents an additional 15 minutes beyond the initial service reported with 97129. The record should support the treatment time and the additional skilled intervention.
How does 97130 differ from 97112?
Use 97130 for skilled intervention focused on cognitive function and strategies for managing activities. Use 97112 when the treatment addresses neuromuscular reeducation, such as movement, balance, or coordination.
Can the same minutes support 97130 and another timed therapy code?
No. The minutes reported for 97130 should represent additional cognitive treatment time, not time already counted toward another timed service.
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.
12,86297116,,Gait training therapy,A,,0.45,0.41,,0.41,NA,0.01,0.87,0.87,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86397124,,Massage therapy,A,,0.35,0.53,,0.53,NA,0.01,0.89,0.89,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86497129,,Ther ivntj 1st 15 min,A,,0.50,0.16,,0.08,,0.01,0.67,0.59,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86597130,,Ther ivntj ea addl 15 min,A,,0.48,0.15,,0.07,,0.00,0.63,0.55,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86697139,,Unlisted therapeutic px,C,,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
12,86797140,,Manual therapy 1/> regions,A,,0.43,0.39,,0.39,NA,0.01,0.83,0.83,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86897150,,Group therapeutic procedures,A,,0.29,0.24,,0.24,NA,0.01,0.54,0.54,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014