CPT 97750 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | • 11 - Office • None |
| Common Modifiers | • GP - Services delivered under an outpatient physical therapy plan of care • 59 - Distinct Procedural Service • None |
| Complexity Level | Low |
National average reimbursement for CPT 97750 by major payers:
$42.77
$34.61
$31.71
$36.41
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 97750 | ||||||
United | 97750 | $34.04 | 1619264413 - NITIKA PANT | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 97750 | $65.23 | 1942650130 - MALIK NASSAN | 362679194 - (IL) HEAD & NECK AND COSMETIC SURGERY ASSOCIATES, LLC | MN | Psychiatry Physician (2084P0800X) |
United | 97750 | $51.59 | 1568752665 - ANDREW KNOX | 390884478 - BELLIN MEMORIAL HOSPITAL INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97750 | $29.77 | 1477997674 - OLGA KOZLOVA | 813062689 - (IL) ADULT AND PEDIATRIC NEUROLOGY | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97750 | $37.25 | 1801849559 - CHARLES MARCUCCILLI | 911780120 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97750 | $34.54 | 1407807746 - SYED KHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IN | Psychiatry Physician (2084P0800X) |
United | 97750 | $55.45 | 1134741028 - SHAHZAIB KHAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 97750 | $65.23 | 1104082734 - JADA JOHNSON | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 97750 | $31.65 | 1609883347 - BRAD BERGER | 362709982 - (IL) PRESENCE BEHAVIORAL HEALTH | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 97750 | $33.41 | 1679526784 - ELTON SMITH | 911031583 | IL | Psychiatry Physician (2084P0800X) |
United | 97750 | $65.23 | 1699713347 - PAULA GEWARGES | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 97750 | $55.45 | 1013098631 - PAUL DOBRANSKY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 97750 | $55.45 | 1609239243 - MEGAN GINSBURG | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 97750 | $33.86 | 1366890857 - STEVEN SHARP | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 97750 | $30.92 | 1679515951 - EUGENE SCHNITZLER | 364035455 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 97750 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97750 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 97750 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 |
|---|---|---|
| 97537-CPT | Low | Community/Work Reintegration Training (Eg Shopping Transportation Money Management Avocational Activities And/Or Work Environment/ Modification Analysis Work Task Analysis Use Of Assistive Technology Device/ Adaptive Equipment) Direct One-On-One Contact Each 15 Minutes (Revised 01/01/13) |
| 97542-CPT | Low | Wheelchair Management/Propulsion Training |
| 97545-CPT | Low | Work Hardening/Condit Initial 2 Hrs |
| 97750-CPT | Low | Physical Performance Test Or Measurement (Eg, Musculoskeletal, Functional Capacity), With Written Report, 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 97750. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97750 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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