$28.25
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.
On this page
CMS RVU26D · Effective 2026-10-01
97150 Group therapy Medicare reimbursement rates in Wisconsin
Therapeutic procedures delivered to two or more patients at the same time are reported once per patient for each skilled group therapy session. Compare 97150 office and facility rates across CMS payment localities in Wisconsin.
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 97150 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$17.47
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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 97150: Group therapeutic procedures for multiple patients
Therapeutic procedures delivered to two or more patients at the same time are reported once per patient for each skilled group therapy session.
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.
CMS billing rules for 97150
- 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 RVU0.29 · 54%
- Practice expense (office) RVU0.24 · 44%
- Malpractice RVU0.01 · 2%
2.7M
Medicare services in 2024 · #65 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.
97150 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
97154
No office rateGrp 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.
$23.28
92508 covers group treatment of speech, language, voice, and communication disorders. 97150 covers other qualifying group therapeutic procedures, such as exercise or balance training.
$34.00
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.
Compare 97150 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.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
$17.47
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 97150 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
12,868
- Code
- 97150
- Physician work
- 0.29
- Practice expense
- 0.24
- Malpractice
- 0.01
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.29 | × 1.000 | 0.2900 |
| Practice expense | 0.24 | × 0.958 | 0.2299 |
| Malpractice | 0.01 | × 0.308 | 0.0031 |
| Total RVUs | 0.5230 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$17.47
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.29 | 1 |
| Practice expense | 0.24 | 0.958 |
| Malpractice | 0.01 | 0.308 |
(0.29 × 1 + 0.24 × 0.958 + 0.01 × 0.308) × $33.4009 = $17.47
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
12,86597130,,Ther ivntj ea addl 15 min,A,,0.48,0.15,,0.07,,0.00,0.63,0.55,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86697139,,Unlisted therapeutic px,C,,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
12,86797140,,Manual therapy 1/> regions,A,,0.43,0.39,,0.39,NA,0.01,0.83,0.83,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86897150,,Group therapeutic procedures,A,,0.29,0.24,,0.24,NA,0.01,0.54,0.54,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,86997151,,Bhv id assmt by phys/qhp,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,87097152,,Bhv id suprt assmt by 1 tech,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,87197153,,Adaptive behavior tx by tech,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,