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See a sample rate comparisonCPT 97112 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.
Muscle Or Nerve Training, A 15-Minute Session Of Therapist-Assisted Activities Designed To Reeducate The Nerves And Muscles In How To Work Together. Focus Is On Movement Balance Coordination Posture And Alignment For Sitting And Standing.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office |
| Common Modifiers | GP - Services delivered under an outpatient physical therapy plan of care CQ - PT services by assistant |
| Complexity Level | Low |
| Medicare Fee Schedule | $32.73 national non-facility rate (2026) · View Medicare rates for 97112 |
| Medicaid Fee Schedule | $26.47 median of the 7 states in the free preview · View Medicaid rates for 97112 |
National average reimbursement for CPT 97112 by major payers:
$39.65
$34.21
$30.85
$34.90
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CPT 97112
5 of 25 sample ratesHigher to lower in this preview
Martha Sandoval-Bernal
Sutter Bay Medical Foundation
$172.46Published rateMichael Dockery
$51.36Published rateMorgan Figurelle
Good Samaritan Hosptial Medical Center
$36.40Published rateBikram Sharma
Saint Anthony Health Affiliates
$28.60Published rateAndres Lerner
$22.98Published rate
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See a sample payer proposalCPT 97112 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97112 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 97112 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 |
|---|---|---|
| 97110-CPT | Low | Therapeutic Procedure One Or, Therapeutic Procedure One Or More Areas Each 15 Minutestherapeutic Exercises To Develop Strength And Endurance Range Of Motion And Flexibility |
| 97112-CPT | Low | Muscle Or Nerve Training, A 15-Minute Session Of Therapist-Assisted Activities Designed To Reeducate The Nerves And Muscles In How To Work Together. Focus Is On Movement Balance Coordination Posture And Alignment For Sitting And Standing. |
| 97113-CPT | Low | Therapeutic Procedure One Or, Therapeutic Procedure One Or More Areas Each 15 Minutesaquatic Therapy With Therapeutic Exercisestherapeutic Procedure One Or More Areas Each 1 5 Minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97112. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97112 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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