$25.40–$26.71
97550 covers the initial 30 minutes of individual caregiver training; 97551 reports qualifying additional time.
On this page
CMS RVU26D · Effective 2026-10-01
97550 Caregiver training Medicare reimbursement rates in Pennsylvania
Reports face-to-face, individual training for a caregiver on strategies that support a patient's functional performance at home or in the community, with the patient absent. Compare 97550 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 97550 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
$51.19–$54.22
2 of 2 localities have a supported rate.
Facility setting
$39.24–$40.66
2 of 2 localities have a 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.
Rehabilitation therapy
About 97550: Individual caregiver functional training
Reports face-to-face, individual training for a caregiver on strategies that support a patient's functional performance at home or in the community, with the patient absent.
A qualified health professional trains a caregiver in practical strategies for supporting a patient's function at home or in the community. The patient is not present during this face-to-face service. Training may address safe transfers, mobility, dressing and other daily activities, communication, feeding, swallowing, problem-solving, or safety practices. For example, an occupational therapist may teach a family member how to assist a patient with dressing and transfers after a stroke. Physical and speech-language therapists may also provide training within their areas of practice, in an outpatient clinic or rehabilitation setting.
Report 97550 for the initial 30 minutes of individual caregiver training. Use 97551 for qualifying additional training time, and use 97552 when the caregiver training is provided to a group. Documentation should identify the caregiver, the patient's functional need, the strategies taught, and the face-to-face training time. The physician fee schedule values the service through work, practice-expense, and malpractice components; the supplied CMS rules identify no additional payment adjustment for this code.
Where the value comes from
- Work RVU1.00 · 63%
- Practice expense (office) RVU0.57 · 36%
- Malpractice RVU0.01 · 1%
12.1K
Medicare services in 2024 · #1371 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.
97550 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$20.88–$22.82
Choose 97550 for individual caregiver training and 97552 when the caregiver training is provided to a group.
$30.98–$33.43
97550 trains a caregiver without the patient present. 97535 describes self-care or home-management training provided to the patient.
$33.41–$36.22
97530 covers therapeutic activities performed with the patient; 97550 is caregiver training conducted without the patient present.
Compare 97550 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
$54.22
Facility
$40.66
Rest Of Pennsylvania →
Office / nonfacility
$51.19
Facility
$39.24
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97550 billing questions
Is the patient present during 97550?
No. The service is face-to-face caregiver training provided without the patient present.
When should 97551 be reported with 97550?
97551 is the add-on code for qualifying additional caregiver-training time after the initial 30 minutes reported with 97550.
How does 97550 differ from 97552?
97550 describes individual caregiver training. Use 97552 for caregiver training delivered to a group.
How does 97550 differ from 97535?
97550 is training for a caregiver while the patient is absent. 97535 is self-care or home-management training provided to the patient.
What should the note support?
Document who received the training, the patient's functional need, the techniques taught, and the face-to-face time spent training the caregiver.
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.
12,89397542,,Wheelchair mngment training,A,,0.48,0.44,,0.44,NA,0.01,0.93,0.93,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89497545,,Work hardening,R,,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
12,89597546,,Work hardening add-on,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,7,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89697550,,Caregiver traing 1st 30 min,A,,1.00,0.57,,0.18,,0.01,1.58,1.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89797551,,Caregiver traing ea addl 15,A,,0.54,0.24,,0.09,,0.00,0.78,0.63,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89897552,,Group caregiver training,A,,0.23,0.42,,0.04,,0.01,0.66,0.28,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,89997597,,Dbrdmt opn wnd 1st 20 cm/<,A,,0.75,2.24,,0.13,,0.05,3.04,0.93,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00