Top billers · Codes · 97535

Who bills 97535?

97535 is the CPT code for: Training for self-care or home management, each 15 minutes. In 2024, 17,873 providers billed 97535 3,689,997 times, with an estimated $72.6M paid by Medicare.

$32.40
2026 PFS national rate (office)
17,873
Providers billing it (2024)
3,689,997
Services billed
$72.6M
Est. Medicare paid
The fee

What does Medicare pay for 97535?

Medicare's 2026 Physician Fee Schedule national rate for 97535 is $32.40 in the office setting. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$32.40
Facility rateNo separate facility rate
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $19.66 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 97535 the most.

The top 5 billers nationally, ranked by 2024 Medicare service volume.

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Marissa Hinnant, OTOccupational Therapist in Private PracticePensacola, FL21,753$385K
2Elizabeth Norman, OTOccupational Therapist in Private PracticeJay, FL15,056$264K
3Imara Paramo, OTOccupational Therapist in Private PracticeMiami, FL14,009$236K
4Pedro Machin, OTROccupational Therapist in Private PracticeMiami, FL13,876$238K
5Jennifer GiegelOccupational Therapist in Private PracticeFrederick, MD12,177$216K

17,868 more providers billed 97535 in 2024. The full ranked list — filtered to your exact territory, with phone numbers and year-over-year history — is one search in Prospect 811.

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The breakdown

Where 97535 gets billed.

Top states by volume

Florida442,563 services
New York379,858 services
California361,512 services
New Jersey304,762 services
Pennsylvania187,455 services
Maryland143,429 services
Illinois142,938 services
Virginia134,110 services

About this code

CMS descriptionTraining for self-care or home management, each 15 minutes
Code typeCPT (Level I HCPCS)
Providers billing it (2024)17,873
Services billed (2024)3,689,997
Avg. Medicare payment per service (2024)$19.66
Where these numbers come from. Rates are CMS's own public fee-schedule files — the Physician Fee Schedule, Clinical Laboratory Fee Schedule, ASP drug pricing, DMEPOS, and the OPPS/ASC addenda — each labeled with its file year on this page; national amounts are shown before geographic adjustment. Codes with no separate rate render the fee schedule's own status in words, never a fake $0. Utilization comes from CMS's public Medicare Provider Utilization & Payment data for 2024, the most recent year released. It covers traditional Medicare fee-for-service only (no commercial insurance, no Medicare Advantage), and CMS suppresses any provider-and-code line with fewer than 11 beneficiaries before publishing, so low-volume billers don't appear at all. "Est. Medicare paid" is each billing line's average Medicare payment times its service count, summed — actual per-claim payment varies by setting and modifiers. For drug and supply codes, a "service" is a billed unit (a milligram, a milliliter, a square centimeter), not a patient visit. Code descriptions are CMS's own, from the utilization files. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

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