{
    "code": "97116",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/97116/2022/A",
    "release_specific_url": "https://localishealth.com/cpt/97116/2022/C",
    "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 Q3 2022?",
        "text": "Medicare paid $30.11 for CPT 97116 in the office (non-facility) setting and $30.11 in a facility under the Q3 2022 Physician Fee Schedule, effective July 2022. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2022, when it decreased 0.8%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2022,
        "quarter": "C",
        "label": "Q3 2022",
        "effective": "July 1 – September 30, 2022",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 30.11,
        "facility": 30.11,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.45,
        "practice_expense_non_facility": 0.4,
        "practice_expense_facility": 0.4,
        "malpractice": 0.02
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.6062,
    "source": {
        "label": "Physician relative value file (Q3 2022)",
        "cms_url": "https://www.cms.gov/files/zip/rvu22c-updated-06172022.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2022/C",
        "file": "PPRRVU22_JUL.csv",
        "row": 17386,
        "sha256": "f0a493a192a21b1faa980aa71d22c8ae064e87b564f51a67e1229fcee376df41"
    },
    "modified_at": "2026-08-04T03:11:49+00:00"
}