Is CPT 97116 overcharged?
97116: Gait (walking) training, each 15 minutes (Physical therapy)
Approximate Medicare national rate
$29.06
Source: CMS Physician Fee Schedule CY2026, Oct release (national, non-facility). National amount; actual Medicare payment varies by locality. Facility-setting physician rate: $29.06 (hospital facility fee billed separately).
What's a reasonable charge?
Commercial insurers typically pay roughly 1.5 to 2.5 times Medicare. If you were billed more than $87.18 for 97116, ask for an itemized bill, request the provider's cash price, and dispute the difference.
Check your whole bill
Duplicates and unbundling are often worth more than a single high price. Scan your bill free