Last updated: July 2026CMS rates · Free lookup

Medicare Fee Schedule Lookup

Search 2026 Medicare reimbursement rates and national payment amounts by CPT, HCPCS, or MS-DRG code. The lookup includes the Physician Fee Schedule, Drug ASP, MS-DRG weights, anesthesia conversion factors, and Clinical Laboratory Fee Schedule data from CMS.

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HCPCS Codes

97164

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Year

2026

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Physician Fee Schedule·97164·National·2026

Current non-facility rate

$67.47▲0.0%

Facility: $67.47

Code description

Pt Re Eval Est Plan Care, Re Evaluation Of Physical Therapy Established Plan Of Care Requiring These Components An Examination Including A Review Of History And Use Of Standardized Tests And Measures Is Required And Revised Plan Of Care Using A Standardized Patient Assessment Instrument And Or Measurable Assessment Of Functional Outcome Typically 20 Minutes Are Spent Face To Face With The Patient And Or Family

Code	Date	State	Non-Facility Fee	Facility Fee	Description
97164	7/2026	N/A	$67.47	$67.47	Pt Re Eval Est Plan Care, Re Evaluation Of Physical Therapy Established Plan Of Care Requiring These Components An Examination Including A Review Of History And Use Of Standardized Tests And Measures Is Required And Revised Plan Of Care Using A Standardized Patient Assessment Instrument And Or Measurable Assessment Of Functional Outcome Typically 20 Minutes Are Spent Face To Face With The Patient And Or Family
97164	4/2026	N/A	$67.47	$67.47	Pt Re Eval Est Plan Care, Re Evaluation Of Physical Therapy Established Plan Of Care Requiring These Components An Examination Including A Review Of History And Use Of Standardized Tests And Measures Is Required And Revised Plan Of Care Using A Standardized Patient Assessment Instrument And Or Measurable Assessment Of Functional Outcome Typically 20 Minutes Are Spent Face To Face With The Patient And Or Family
97164	1/2026	N/A	$67.47	$67.47	Pt Re Eval Est Plan Care, Re Evaluation Of Physical Therapy Established Plan Of Care Requiring These Components An Examination Including A Review Of History And Use Of Standardized Tests And Measures Is Required And Revised Plan Of Care Using A Standardized Patient Assessment Instrument And Or Measurable Assessment Of Functional Outcome Typically 20 Minutes Are Spent Face To Face With The Patient And Or Family

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Medicaid comparison

See what state Medicaid programs pay for the same codes

48 state Medicaid agencies publish their own physician fee schedule, and the rate for a single code can differ several times over between them. Rates for 99213, 99214, 99203, 99204, 99285 are free in every state that prices them, with no login.

16,416 codes and 616,564 published rates, taken from the files the state agencies publish themselves.

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$97.87

97165Ot Eval Low Complex 30 Min, Occupational Therapy Evaluation Low Complexity Requiring These Components An Occupational Profile And Medical And Therapy History Which Includes A Brief History Including Review Of Medical And Or Therapy Records Relating To The Presenting Problem An Assessment S That Identifies 1 3 Performance Deficits Ie Relating To Physical Cognitive Or Psychosocial Skills That Result In Activity Limitations And Or Participation Restrictions And Clinical Decision Making Of Low Complexity Which Includes An Analysis Of The Occupational Profile Analysis Of Data From Problem Focused Assessment S And Consideration Of A Limited Number Of Treatment Options Patient Presents With No Comorbidities That Affect Occupational Performance Modification Of Tasks Or Assistance Eg Physical Or Verbal With Assessment S Is Not Necessary To Enable Completion Of Evaluation Component Typically 30 Minutes Are Spent Face To Face With The Patient And Or Family

$100.54

Methodology

Rates are sourced directly from CMS Physician Fee Schedule files, indexed quarterly. Non-facility and facility prices are calculated using the published GPCI for each locality and the year's conversion factor.

View CMS Physician Fee Schedule