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See a sample rate comparisonCPT 97139 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.
Therapeutic Procedure One Or, Therapeutic Procedure One Or More Areas Each 15 Minutesunlisted Therapeutic Procedure (Specify) Therapeutic Procedure One Or More Areas Each 15 Minutes
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office 99 - Other POS |
| 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 97139 |
| Medicaid Fee Schedule | $13.31 median of the 7 states in the free preview · View Medicaid rates for 97139 |
National average reimbursement for CPT 97139 by major payers:
$111.45
$18.87
$15.37
$18.04
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CPT 97139
5 of 25 sample ratesHigher to lower in this preview
Daniel Bateman
Dartmouth-Hitchcock Clinic
$102.58Published rateRestorative Health Rehabilitation Inc
$55.00Published rateAll Ways Homecare Inc
$35.00Published rateEdgar Hernandez
$19.14Published rateRyan Frederiksen
Professional Radiology, Inc.
$7.73Published rate
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See a sample payer proposalCPT 97139 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97139 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 97139 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 |
|---|---|---|
| 97130-CPT | Low | Ther Ivntj Ea Addl 15 Min, Therapeutic Interventions That Focus On Cognitive Function Eg Attention Memory Reasoning Executive Function Problem Solving And Or Pragmatic Functioning And Compensatory Strategies To Manage The Performance Of An Activity Eg Managing Time Or Schedules Initiating Organizing And Sequencing Tasks Direct One On One Patient Contact Each Additional 15 Minutes List Separately In Addition To Code For Primary Procedure |
| 97139-CPT | Low | Therapeutic Procedure One Or, Therapeutic Procedure One Or More Areas Each 15 Minutesunlisted Therapeutic Procedure (Specify) Therapeutic Procedure One Or More Areas Each 15 Minutes |
| 97140-CPT | Low | Manual Therapy 1 Regions, Manual Therapy Techniques Eg Mobilization Manipulation Manual Lymphatic Drainage Manual Traction 1 Or More Regions Each 15 Minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97139. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97139 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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