$27.92–$29.96
Choose 97110 for exercises addressing strength, endurance, range of motion, or flexibility. Choose 97530 for dynamic performance of a functional task, such as transferring or lifting.
On this page
CMS RVU26D · Effective 2026-10-01
97530 Therapeutic activities Medicare reimbursement rates in Pennsylvania
One-on-one therapy using dynamic functional tasks, such as transfers, lifting, and reaching, to improve daily performance, reported in 15-minute units. Compare 97530 office and facility rates across CMS payment localities in Pennsylvania.
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 97530 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$33.41–$36.22
2 of 2 localities have a supported rate.
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 97530: Dynamic functional therapeutic activities, per 15 minutes
One-on-one therapy using dynamic functional tasks, such as transfers, lifting, and reaching, to improve daily performance, reported in 15-minute units.
This timed service involves direct, one-on-one treatment using dynamic activities that improve functional performance. A physical or occupational therapist may have a patient practice sit-to-stand transfers, lift and carry an object, squat to retrieve an item, or reach overhead for a household task. The activity is selected and adjusted to address the patient's functional limitation, rather than performed simply as an exercise repetition. Therapists and qualified therapy assistants furnish the service in outpatient practices, hospital outpatient departments, and skilled nursing facilities providing Part B therapy.
Report units from documented direct treatment minutes. Under Medicare's 8-minute rule, total minutes across timed therapy services determine the day's available units; when several services are furnished, allocate units according to the minutes spent on each. Document the activity, skilled intervention, treatment time, and connection to a functional goal. Use the appropriate therapy plan modifier and, when the assistant contribution meets Medicare's threshold, CQ or CO. Report the therapy service as a whole, without a professional-component modifier. Medicare reduces practice expense for the second and later therapy units on the same day.
CMS billing rules for 97530
- 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 RVU0.44 · 42%
- Practice expense (office) RVU0.60 · 57%
- Malpractice RVU0.01 · 1%
44.7M
Medicare services in 2024 · #4 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.
97530 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$30.98–$33.43
97535 covers training in daily living skills, such as dressing, bathing, meal preparation, or adaptive equipment use. 97530 covers dynamic functional movement tasks such as transfers, lifting, and reaching.
$31.43–$33.74
97112 focuses on neuromuscular reeducation of balance, coordination, or movement control. Choose 97530 when the skilled treatment centers on performing a dynamic functional task.
$17.36–$18.60
97150 covers therapy delivered simultaneously to two or more patients. 97530 requires direct, one-on-one contact and is reported in 15-minute units.
Compare 97530 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$36.22
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$33.41
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
Physical therapy
Compare selected outpatient therapy base rates before claim-level adjustments.
97530 billing questions
How is 97530 different from therapeutic exercise (97110)?
97110 covers exercises to improve strength, endurance, range of motion, or flexibility. Choose 97530 for a dynamic functional task, such as a transfer or lifting activity, with a documented functional goal.
How many units can be billed for a session?
If 97530 is the only timed therapy service, at least 8 minutes of direct treatment supports one unit under Medicare's 8-minute rule. When other timed services are furnished, total their direct minutes to determine available units, then allocate those units according to time spent on each service.
Can 97530 be billed with a therapy evaluation on the same day?
Yes, when the evaluation and a distinct skilled treatment are both performed and separately documented. Do not append modifier 59 or an X modifier solely because both occur on the same date.
Which therapy modifiers are used on Medicare claims?
Use GP or GO for treatment under the applicable physical or occupational therapy plan of care. Add CQ or CO when a physical therapist assistant or occupational therapy assistant, respectively, furnishes more than 10% of the service under Medicare's de minimis policy.
Can 97530 be billed when working with two patients at once?
97530 requires direct, one-on-one contact. Use 97150 for group therapy furnished simultaneously to two or more patients; separately documented individual treatment time may support 97530.
Does the multiple procedure reduction lower every unit?
The therapy unit with the highest practice expense is paid without the reduction. Medicare reduces practice expense for the second and later therapy units on the same day, whether they are additional 97530 units or other therapy services.
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.
12,88697170,,Athletic trn eval mod cmplx,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
12,88797171,,Athletic trn eval high cmplx,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
12,88897172,,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