{
    "code": "97116",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/97116/2020/A",
    "release_specific_url": "https://localishealth.com/cpt/97116/2020/D",
    "description": "Direct therapy focused specifically on how a patient walks: step length, weight shift, heel strike, safe handling of a cane, walker or crutches, and getting up and down stairs and curbs. The therapist analyses the walking pattern and drills corrections rather than working on general conditioning. Time is counted in 15-minute blocks of one-on-one contact.",
    "answer": {
        "question": "How much did Medicare pay for CPT 97116 in Q4 2020?",
        "text": "Medicare paid $31.04 for CPT 97116 in the office (non-facility) setting and $31.04 in a facility under the Q4 2020 Physician Fee Schedule, effective October 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2020, when it increased 0.2%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2020,
        "quarter": "D",
        "label": "Q4 2020",
        "effective": "October 1 – December 31, 2020",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 31.04,
        "facility": 31.04,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.45,
        "practice_expense_non_facility": 0.39,
        "practice_expense_facility": 0.39,
        "malpractice": 0.02
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0896,
    "source": {
        "label": "Physician relative value file (Q4 2020)",
        "cms_url": "https://www.cms.gov/files/zip/rvu20d-updated-11232020.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2020/D",
        "file": "PPRRVU20_OCT.csv",
        "row": 17048,
        "sha256": "504fd19a9bc1d2eeebb290adac2d7de6c56d4e86cde7532df1862fe42494d319"
    },
    "modified_at": "2026-08-04T03:10:00+00:00"
}