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See a sample rate comparisonCPT 97533 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.
Sensory Integrative Techniques, Sensory Integrative Techniques To Enhance Sensory Processing And Promote Adaptive Responses To Environmental Demands Direct (One On One) Patient Contact By The Provider Each 15 Minutes
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office 15 - Mobile Unit |
| Common Modifiers | GO - Services delivered under an outpatient occupational therapy plan of care GP - Services delivered under an outpatient physical therapy plan of care |
| Complexity Level | Low |
| Medicare Fee Schedule | $60.79 national non-facility rate (2026) · View Medicare rates for 97533 |
| Medicaid Fee Schedule | $51.37 median of the 7 states in the free preview · View Medicaid rates for 97533 |
National average reimbursement for CPT 97533 by major payers:
$56.18
$42.44
$48.41
$52.36
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CPT 97533
5 of 25 sample ratesHigher to lower in this preview
Slidell Memorial Hospital, St Tammany Parish Hospital Service District #2
Slidell Memorial Hospital
$62.25Published rateSt Joseph Regional Health Center, St Joseph Ambulatory Surgery
St Joseph Regional Health Center
$44.88Published rateBig Spring Vamc
$32.02Published rateTexas Radiology Associates LLP
Texas Radiology Associates, LLP
$29.68Published ratePhilip Munschauer
Professional Radiology, Inc.
$24.03Published rate
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See a sample payer proposalCPT 97533 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97533 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 97533 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 |
|---|---|---|
| 97530-CPT | Low | Activity Therapy, Activity Therapy Provided One-On-One To Improve A Persons Ability To Participate In Or Perform Daily Physical Social Or Other Life Activities. The Therapy Includes Active Body Movements Such As Lifting Reaching Or Bending. |
| 97533-CPT | Low | Sensory Integrative Techniques, Sensory Integrative Techniques To Enhance Sensory Processing And Promote Adaptive Responses To Environmental Demands Direct (One On One) Patient Contact By The Provider Each 15 Minutes |
| 97535-CPT | Low | Self Care Mngment Training, Self Care Home Management Training Eg Activities Of Daily Living Adl And Compensatory Training Meal Preparation Safety Procedures And Instructions In Use Of Assistive Technology Devices Adaptive Equipment Direct One On One Contact 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 97533. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97533 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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