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See a sample rate comparisonCPT 97014 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office 49 - Independent Clinic |
| Common Modifiers | GP - Services delivered under an outpatient physical therapy plan of care 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 97014 |
| Medicaid Fee Schedule | $12.305 median of the 8 states in the free preview · View Medicaid rates for 97014 |
National average reimbursement for CPT 97014 by major payers:
$20.10
$15.10
$14.76
$14.73
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CPT 97014
5 of 25 sample ratesHigher to lower in this preview
Anne Kinderman
$78.41Published rateJoseph Casas
Providence Medical Foundation
$30.74Published rateDonna Thompson
Redlands Family Practice Medical Group
$17.91Published rateRavindra Nallamothu
Adventist Health Clearlake Hospital Inc
$14.80Published rateArmin Tahoori
Taho Medical Group
$12.15Published rate
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See a sample payer proposalCPT 97014 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97014 code is part of the Medicine Services and Procedures services used for Physical Medicine and Rehabilitation Evaluations. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 97014 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 97012-CPT | Low | Application Of A Modality To O, Application Of A Modality To One Or More Areas Tractionmechanical Application Of A Modality To One Or More Areas Traction |
| 97014-CPT | Low | Application Of A Modality To O, Application Of A Modality To One Or More Areas Electricalstimulation(Unattended) Application Of A Modality To One Or More Areas Electrical |
| 97016-CPT | Low | Application Of A Modality To O, Application Of A Modality To One Or More Areasvasopneumatic Devices Application Of A Modality To One Or More Areas |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97014. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97014 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
CPT 97014 is a Physical Medicine and Rehabilitation Evaluation code under Medicine Services and Procedures, signifying a moderate-complexity encounter. It stands apart from other evaluation codes primarily due to requiring more provider time, a moderate level of Medical Decision-Making (MDM), and more comprehensive documentation. Unlike lower-level codes that entail less time and simpler assessments, CPT 97014 typically applies to complex situations such as managing multiple diagnoses, overseeing medication, or interpreting tests. This generally results in higher reimbursement and demands more detailed record-keeping. For specific reimbursement rates for CPT 97014 based on your location, you can utilize Payerprice's fee schedule lookup tool.