Billing code 97150: Group therapyMedicare rate & RVUs in Virginia
Therapeutic procedures delivered to two or more patients at the same time are reported once per patient for each skilled group therapy session.
Medicare pays $17.80–$20.02 for 97150 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 97150 covers
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.
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 97150 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $20.02 | Unavailable |
| Virginia | $17.80 | Unavailable |
How the 97150 rate is calculated
Each of 97150’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 · 97150
RVUs × geographic indexes × conversion factor
Work0.29
0.29 RVUs× 1.000 GPCI
Practice expense0.24
0.24 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.5400
Conversion factor
$33.4009
Medicare rate
$18.04
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97150
The CMS indicators that decide how 97150 is paid alongside other services.
CMS payment indicators · 97150
Group therapy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 5 | Therapy reduction: practice expense of the second and later units is reduced. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 7 | Therapy service: the split doesn’t apply. |
What modifiers do to the payment
Modifier CQ · payment effect
With and without the modifier
97150 without CQ · national office
$18.04
Group therapy
97150-CQ · Allowed amount unchanged
$18.04
Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.
97150 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 97110Therapeutic exercise
- 97110 is timed and requires direct one-on-one contact for its 15-minute units. Report 97150 when the clinician treats two or more patients at once in a qualifying group session.
- 97154Grp adapt bhv tx by tech
- 97154 is group adaptive behavior treatment delivered by a technician under an adaptive behavior treatment plan, in 15-minute units. 97150 covers rehabilitative group therapeutic procedures.
- 92508Speech therapy
- 92508 covers group treatment of speech, language, voice, and communication disorders. 97150 covers other qualifying group therapeutic procedures, such as exercise or balance training.
- 97530Therapeutic activities
- 97530 requires direct one-on-one functional activity training in timed units. Use 97150 for qualifying group therapeutic procedures when the clinician treats multiple patients simultaneously.
97150 billing questions
How many units of 97150 can be billed for one session?
Report one unit per patient per group session. A longer session does not increase units, and group-session minutes are not added to timed codes for the 8-minute rule calculation.
Can 97150 be billed on the same day as individual codes such as 97110 or 97530?
Yes, when the one-on-one service occurs during a distinct time interval. Document separate times; use modifier 59 or an appropriate X modifier only when an applicable NCCI edit permits separate reporting and its criteria are met.
Do all patients in the group need to do the same activity?
No. Patients can perform different activities while the clinician treats two or more patients at once and remains in constant attendance.
Which modifiers are used with 97150?
Medicare requires GP for physical therapy, GO for occupational therapy, or GN for speech-language pathology, according to the plan of care. Add CQ for physical therapist assistant services or CO for occupational therapy assistant services when Medicare's assistant-modifier criteria are met.
Does the therapy multiple procedure payment reduction affect 97150?
Yes. Practice expense is reduced for the second and later therapy units billed for the patient on the same day, which can include the group unit.
Should speech therapy groups use 97150 or 92508?
Group treatment of speech, language, voice, or communication disorders is typically reported with 92508. Use 97150 for other qualifying group therapeutic procedures.
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
Fee sheets
Put 97150 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →