Billing code 97129: Cognitive therapyMedicare rate & RVUs in Illinois
Reports direct, individual cognitive treatment addressing skills such as attention, memory, reasoning, or executive function and strategies for daily activities.
Medicare pays $22.10–$22.95 for 97129 in the office in Illinois, from Rest Of Illinois to Chicago. 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 97129 covers
This service covers one-on-one treatment to improve or compensate for cognitive difficulties that interfere with everyday tasks. Occupational therapists and speech-language pathologists commonly use structured activities and functional tasks to address attention, memory, reasoning, problem solving, organization, or sequencing. Treatment may follow a stroke or traumatic brain injury, for example, when cognitive limitations affect a patient’s ability to manage a schedule or complete a multistep task. It is furnished in settings such as an outpatient rehabilitation clinic or skilled nursing facility.
Report 97129 for the initial 15 minutes of direct cognitive intervention with the individual patient. The note should identify the cognitive limitation, functional goal, treatment activity or compensatory strategy, skilled therapist involvement, time, and patient response. For additional treatment time, 97130 is the related add-on code; it represents each additional 15-minute increment. Choose this service for cognitive intervention rather than exercise for strength or range of motion, balance or coordination retraining, or a cognitive evaluation without treatment.
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 97129 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$22.10 to $22.95
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $22.95 | $20.27 |
| East St. Louis | $22.29 | $19.83 |
| Rest Of Illinois | $22.10 | $19.66 |
| Suburban Chicago | $22.90 | $20.15 |
How the 97129 rate is calculated
Each of 97129’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 · 97129
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.50Practice expense 0.16Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 97129
97129 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 97129
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$22.38
The facility rate would be $19.71 (+$2.67). In a facility, the facility bills its own costs separately.
97129 compared with similar codes
Compare codes
97129 vs 97130 vs 97112 vs 97110: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 97130Cognitive intervention
- 97129 covers the initial 15 minutes of cognitive intervention; 97130 reports each additional 15-minute increment and is used with the primary service.
- 97112Neuromuscular reeducation
- Choose 97112 for neuromuscular reeducation focused on movement control, balance, or coordination. Choose 97129 for direct treatment of cognitive skills or compensatory strategies.
- 97110Therapeutic exercise
- 97110 covers therapeutic exercise for physical impairments such as weakness or limited range of motion. 97129 targets cognitive function and performance of activities.
97129 billing questions
When should 97129 be selected instead of 97112?
Use 97129 when the skilled intervention targets cognitive functions such as attention, memory, reasoning, or task sequencing. Use 97112 when the treatment focuses on neuromuscular control, balance, coordination, or movement patterns.
Can 97130 be reported with 97129?
Yes. 97129 represents the initial 15 minutes of cognitive intervention, and 97130 is the add-on code for each additional 15-minute increment.
What should the treatment note support?
Document the functional cognitive problem, treatment goal, specific skilled activity or compensatory strategy, direct treatment time, and the patient’s response or progress.
Is 97129 an evaluation code?
No. It reports cognitive treatment. A cognitive assessment or rehabilitation evaluation is distinct from the direct intervention represented by 97129.
How is 97129 different from therapeutic exercise?
97129 addresses cognitive skills and strategies for managing activities. Use 97110 for skilled exercise directed at strength, endurance, range of motion, or flexibility.
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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