97150 Group therapy Medicare reimbursement rates in Idaho

This code covers skilled therapy delivered to two or more patients simultaneously, with the treating clinician in constant attendance rather than providing continuous one-on-one care. Patients may work on the same or different activities, such as skilled exercise after joint replacement, aquatic exercise, balance training, or an occupational therapy fine motor group. Physical therapists, occupational therapists, and, for appropriate services, speech-language pathologists or assistants working under required supervision provide it in private practices, outpatient clinics, and skilled nursing or rehabilitation settings billing Part B.

The code is untimed. Report one unit per patient per group session regardless of session length, with the GP, GO, or GN modifier matching the plan of care. Documentation should identify the session time, group activities, each patient's participation and response, the skilled interventions, and the connection to plan-of-care goals. Bill this therapy service without a professional-component modifier 26 split. Under the therapy multiple procedure payment reduction, practice expense is reduced for the second and later therapy units billed for the patient that day.