Cost analysis for CPT 97535 — Training for self-care or home management, each 15 minutes
Average Medicare Payment
$20.41
2023 data
Total Payments (2023)
$68.8M
Services (2023)
3.4M
Price Change (2014–2023)
-10.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $22.82 | $21.7M | 926.4K | — |
| 2015 | $22.68 | $24.7M | 1.1M | -0.6% |
| 2016 | $22.69 | $27.0M | 1.2M | +0.0% |
| 2017 | $22.63 | $29.2M | 1.3M | -0.3% |
| 2018 | $22.50 | $34.8M | 1.5M | -0.6% |
| 2019 | $22.27 | $41.4M | 1.8M | -1.0% |
| 2020 | $22.31 | $42.7M | 1.9M | +0.2% |
| 2021 | $22.03 | $54.4M | 2.4M | -1.3% |
| 2022 | $21.11 | $62.1M | 2.9M | -4.2% |
| 2023 | $20.41 | $68.8M | 3.4M | -3.3% |
The most expensive state pays 1.3x more than the cheapest for this procedure. NY averages $23.28 vs WV at $17.84.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NY | $23.28 | $8.0M | 345.0K | 1.6K |
| DC | $22.31 | $201.6K | 9.0K | 56 |
| CA | $21.93 | $7.6M | 347.5K | 1.6K |
| CT | $21.80 | $675.0K | 31.0K | 228 |
| MA | $21.73 | $2.1M | 97.6K | 581 |
| NJ | $21.59 | $6.3M | 292.6K | 1.5K |
| RI | $21.55 | $177.2K | 8.2K | 49 |
| PR | $21.55 | $2.5K | 118 | 4 |
| AE | $21.28 | $11.4K | 537 | 3 |
| MD | $21.11 | $2.8M | 131.8K | 729 |
| HI | $20.96 | $92.4K | 4.4K | 32 |
| WA | $20.69 | $891.2K | 43.1K | 299 |
| MT | $20.63 | $99.1K | 4.8K | 43 |
| SD | $20.58 | $143.8K | 7.0K | 21 |
| DE | $20.57 | $548.4K | 26.7K | 107 |
| VT | $20.55 | $75.9K | 3.7K | 50 |
| UT | $20.48 | $277.8K | 13.6K | 81 |
| CO | $20.38 | $1.2M | 56.8K | 336 |
| MN | $20.32 | $836.3K | 41.2K | 447 |
| NH | $20.11 | $509.8K | 25.3K | 140 |
| AK | $20.11 | $186.2K | 9.3K | 33 |
| NV | $20.05 | $389.4K | 19.4K | 136 |
| PA | $20.01 | $3.4M | 171.8K | 667 |
| VA | $20.00 | $2.2M | 108.1K | 475 |
| OR | $19.88 | $439.3K | 22.1K | 162 |
| VI | $19.84 | $5.8K | 292 | 3 |
| ME | $19.83 | $510.5K | 25.7K | 143 |
| MI | $19.71 | $1.6M | 78.9K | 653 |
| ND | $19.69 | $178.9K | 9.1K | 34 |
| WY | $19.60 | $138.7K | 7.1K | 39 |
| LA | $19.59 | $275.8K | 14.1K | 149 |
| OK | $19.42 | $471.8K | 24.3K | 101 |
| TX | $19.36 | $1.6M | 81.2K | 494 |
| AZ | $19.24 | $1.4M | 74.0K | 694 |
| FL | $19.22 | $6.7M | 349.3K | 1.1K |
| WI | $19.17 | $808.9K | 42.2K | 204 |
| IA | $19.09 | $483.5K | 25.3K | 146 |
| NE | $19.04 | $298.6K | 15.7K | 44 |
| GA | $19.02 | $1.5M | 76.8K | 391 |
| IL | $18.91 | $3.1M | 163.1K | 506 |
| NC | $18.86 | $1.7M | 89.8K | 450 |
| AR | $18.79 | $242.6K | 12.9K | 105 |
| OH | $18.71 | $1.5M | 80.1K | 387 |
| AL | $18.70 | $633.0K | 33.9K | 286 |
| SC | $18.67 | $1.1M | 60.0K | 251 |
| NM | $18.66 | $172.6K | 9.2K | 59 |
| TN | $18.63 | $944.1K | 50.7K | 192 |
| ID | $18.59 | $63.7K | 3.4K | 30 |
| IN | $18.58 | $1.2M | 64.0K | 261 |
| MO | $18.49 | $988.3K | 53.5K | 164 |
| KY | $18.38 | $843.6K | 45.9K | 289 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| George Siegel | Occupational Therapist in Private Practice | CA | $324.9K | 15.8K | $20.59 |
| Marissa Hinnant | Occupational Therapist in Private Practice | FL | $281.0K | 14.8K | $18.96 |
| Pedro Machin | Occupational Therapist in Private Practice | FL | $240.3K | 13.8K | $17.42 |
| Imara Paramo | Occupational Therapist in Private Practice | FL | $222.4K | 12.9K | $17.19 |
| Zakari Tata | Family Practice | MI | $175.4K | 8.8K | $20.00 |
| Ana Vazquez | Occupational Therapist in Private Practice | NY | $171.8K | 6.8K | $25.38 |
| Kelly Robbins | Occupational Therapist in Private Practice | FL | $151.7K | 8.8K | $17.24 |
| Meda Osborne | Occupational Therapist in Private Practice | AK | $139.6K | 7.5K | $18.68 |
| Gayle Reed | Physical Therapist in Private Practice | FL | $137.7K | 7.2K | $19.10 |
| Claudia Ferreiro | Occupational Therapist in Private Practice | FL | $130.6K | 6.8K | $19.10 |
| Justin Turner | Internal Medicine | MS | $128.1K | 7.2K | $17.88 |
| Tracy Walck | Occupational Therapist in Private Practice | FL | $127.9K | 6.8K | $18.90 |
| Jennifer Giegel | Occupational Therapist in Private Practice | MD | $113.7K | 5.5K | $20.70 |
| Iliana Holguin | Occupational Therapist in Private Practice | FL | $108.9K | 6.4K | $16.98 |
| Pamela Mack-Rainey | Occupational Therapist in Private Practice | IL | $108.6K | 5.9K | $18.40 |
| Ashley Arafat | Occupational Therapist in Private Practice | MI | $108.6K | 5.7K | $19.12 |
| Taylor Lancaster | Diagnostic Radiology | OK | $107.4K | 4.4K | $24.33 |
| Liza Verne | Occupational Therapist in Private Practice | OH | $103.6K | 6.1K | $16.89 |
| Terry Revere | Occupational Therapist in Private Practice | MI | $100.8K | 5.3K | $19.16 |
| Jonathan Pimentel | Occupational Therapist in Private Practice | NY | $93.9K | 3.5K | $26.74 |
Based on the data, CPT 97535 shows a 1.3x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 10.6% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.