Code Reality Check
97530 reimbursement rate: Therapeutic activities, 15 min
Therapeutic activities, 15 min (CPT 97530) pays a median $75.00 in California and $16.60 in Missouri, against a Medicare anchor of $40.83. 51 of 51 states clear the publication floor.
spread 4.5x top to bottom
Medicare anchor $40.83
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| California | $75.00 | 1.84x | $75–$121 · P90 $202 | 97,958 | Benchmark |
| New York | $74.62 | 1.83x | $29–$75 · P90 $84 | 323,088 | Benchmark |
| Colorado | $70.00 | 1.71x | $60–$70 · P90 $85 | 9,810 | Benchmark |
| Connecticut | $60.79 | 1.49x | $27–$75 · P90 $84 | 5,456 | Benchmark |
| Nevada | $46.00 | 1.13x | $27–$75 · P90 $115 | 1,355 | Benchmark |
| New Jersey | $45.18 | 1.11x | $29–$75 · P90 $79 | 14,607 | Benchmark |
| Delaware | $42.60 | 1.04x | $26–$75 · P90 $77 | 601 | Benchmark |
| Wyoming | $42.45 | 1.04x | $35–$49 · P90 $75 | 565 | Benchmark |
| Oregon | $40.32 | 0.99x | $26–$75 · P90 $122 | 1,627 | Benchmark |
| New Hampshire | $40.13 | 0.98x | $33–$58 · P90 $65 | 5,038 | Benchmark |
| Washington | $39.82 | 0.98x | $27–$75 · P90 $124 | 3,056 | Benchmark |
| Maine | $39.80 | 0.97x | $31–$59 · P90 $71 | 11,046 | Benchmark |
| Massachusetts | $39.69 | 0.97x | $27–$75 · P90 $84 | 6,946 | Benchmark |
| Georgia | $38.88 | 0.95x | $29–$57 · P90 $78 | 54,178 | Benchmark |
| Utah | $38.87 | 0.95x | $26–$75 · P90 $115 | 885 | Benchmark |
| Hawaii | $36.56 | 0.90x | $26–$75 · P90 $83 | 744 | Benchmark |
| Vermont | $35.66 | 0.87x | $25–$75 · P90 $75 | 1,279 | Benchmark |
| New Mexico | $34.88 | 0.85x | $26–$75 · P90 $92 | 915 | Benchmark |
| Montana | $33.85 | 0.83x | $24–$75 · P90 $101 | 437 | Benchmark |
| Idaho | $32.58 | 0.80x | $26–$75 · P90 $80 | 513 | Benchmark |
| North Dakota | $32.39 | 0.79x | $27–$75 · P90 $76 | 285 | Benchmark |
| Arizona | $32.32 | 0.79x | $26–$75 · P90 $89 | 3,171 | Benchmark |
| Wisconsin | $31.66 | 0.78x | $30–$97 · P90 $123 | 35,552 | Benchmark |
| Minnesota | $31.33 | 0.77x | $30–$52 · P90 $98 | 7,798 | Benchmark |
| Alabama | $30.96 | 0.76x | $26–$41 · P90 $75 | 1,854 | Benchmark |
| Rhode Island | $30.80 | 0.75x | $26–$41 · P90 $60 | 8,839 | Benchmark |
| Nebraska | $30.31 | 0.74x | $24–$67 · P90 $80 | 506 | Benchmark |
| South Dakota | $30.10 | 0.74x | $26–$70 · P90 $85 | 230 | Benchmark |
| Iowa | $30.10 | 0.74x | $25–$59 · P90 $79 | 1,122 | Benchmark |
| Alaska | $29.54 | 0.72x | $25–$75 · P90 $82 | 323 | Benchmark |
| Florida | $29.14 | 0.71x | $26–$75 · P90 $75 | 14,946 | Benchmark |
| Mississippi | $29.01 | 0.71x | $24–$64 · P90 $80 | 579 | Benchmark |
| Louisiana | $28.98 | 0.71x | $25–$75 · P90 $83 | 1,255 | Benchmark |
| Pennsylvania | $28.85 | 0.71x | $28–$66 · P90 $75 | 12,342 | Benchmark |
| Maryland | $28.51 | 0.70x | $24–$73 · P90 $76 | 3,818 | Benchmark |
| Tennessee | $28.51 | 0.70x | $24–$41 · P90 $75 | 4,968 | Benchmark |
| Oklahoma | $28.18 | 0.69x | $24–$61 · P90 $75 | 1,019 | Benchmark |
| District of Columbia | $27.76 | 0.68x | $22–$67 · P90 $78 | 1,222 | Benchmark |
| Texas | $27.41 | 0.67x | $24–$53 · P90 $75 | 28,851 | Benchmark |
| Michigan | $27.23 | 0.67x | $24–$49 · P90 $79 | 5,531 | Benchmark |
| South Carolina | $27.00 | 0.66x | $24–$34 · P90 $75 | 5,900 | Benchmark |
| Illinois | $27.00 | 0.66x | $21–$55 · P90 $75 | 11,349 | Benchmark |
| Indiana | $27.00 | 0.66x | $23–$30 · P90 $42 | 52,217 | Benchmark |
| North Carolina | $26.89 | 0.66x | $24–$29 · P90 $30 | 97,519 | Benchmark |
| Arkansas | $25.71 | 0.63x | $18–$44 · P90 $75 | 952 | Benchmark |
| Virginia | $24.72 | 0.61x | $21–$30 · P90 $45 | 13,657 | Benchmark |
| Kansas | $22.54 | 0.55x | $17–$34 · P90 $75 | 1,492 | Benchmark |
| West Virginia | $21.77 | 0.53x | $18–$29 · P90 $56 | 1,459 | Benchmark |
| Ohio | $20.85 | 0.51x | $17–$32 · P90 $57 | 79,008 | Benchmark |
| Kentucky | $20.81 | 0.51x | $17–$31 · P90 $48 | 18,867 | Benchmark |
| Missouri | $16.60 | 0.41x | $16–$36 · P90 $58 | 42,875 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 97530. Reddenda. https://reddenda.health/code/97530/
Derivation federally mandated TiC MRFs, verified to provider identity999,610 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0