101 C.M.R. 339.04
(1) Fee Schedule.
3
Final Adoption
Date Published in Mass Register: June 6, 2025
101 CMR 339.00: RATES FOR RESTORATIVE SERVICES
Service Allowable Fee Service Description Code
Special Otorhinolaryngologic Services 92507 $73.64 Treatment of speech, language, voice, communication,
and/or auditory processing disorder; individual (maximum one unit per visit)
92508 $31.53 Treatment of speech, language, voice, communication,
and/or auditory processing disorder; group, two or more individuals (maximum one unit per visit)
92521 $102.21 Evaluation of speech fluency (e.g., stuttering, cluttering) 92521 HA $102.21 Evaluation of speech fluency (e.g., stuttering, cluttering)
(for patients aged 21 or younger)
92521 TF $102.21 Evaluation of speech fluency (e.g., stuttering, cluttering)
(for developmentally disabled adults aged 22 or older)
92522 $85.32 Evaluation of speech sound production (e.g., articulation,
phonological process, apraxia, dysarthria)
92522 HA $85.32 Evaluation of speech sound production (e.g., articulation,
phonological process, apraxia, dysarthria) (for patients aged 21 or younger)
92522 TF $85.32 Evaluation of speech sound production (e.g., articulation,
phonological process, apraxia, dysarthria) (for developmentally disabled adults aged 22 or older)
92523 $175.24 Evaluation of speech sound production (e.g., articulation,
phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language)
92523 HA $175.24 Evaluation of speech sound production (e.g., articulation,
phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language) (for patients aged 21 or younger)
92523 TF $175.24 Evaluation of speech sound production (e.g., articulation,
phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (e.g., receptive and expressive language) (for developmentally disabled adults aged 22 or older)
92524 $83.97 Behavioral and qualitative analysis of voice and resonance 92524 HA $83.97 Behavioral and qualitative analysis of voice and resonance
(for patients aged 21 or younger)
92524 TF $83.97 Behavioral and qualitative analysis of voice and resonance
(for developmentally disabled adults aged 22 or older)
92526 $65.33 Treatment of swallowing dysfunction and/or oral function
for feeding (maximum one unit per visit)
Evaluative and Therapeutic Services 92605 $79.26 Evaluation for prescription of non-speech-generating
augmentative and alternative communication device, face- to-face with the patient; first hour
92606 $19.82 Therapeutic service(s) for the use of non-speech-
generating device, including programming and modification
92607 $95.90 Evaluation for prescription for speech-generating
augmentative and alternative communication device, face- to-face with the patient; first hour
92608 $37.70 Evaluation for prescription for speech-generating
augmentative and alternative communication device, face- to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)
92609 $80.04 Therapeutic services for the use of speech-generating
device, including programming and modification
92610 $65.90 Evaluation of oral and pharyngeal swallowing function
(per hour, maximum of one hour)
92630 $18.06 Auditory rehabilitation; prelingual hearing loss 92633 $18.06 Auditory rehabilitation; postlingual hearing loss
Physical Medicine and Rehabilitation
4
Final Adoption
Date Published in Mass Register: June 6, 2025
101 CMR 339.00: RATES FOR RESTORATIVE SERVICES
Service Allowable Fee Service Description Code 97161 $77.50 Physical therapy evaluation – Low complex – 20 min 97162 $77.50 Physical therapy evaluation- Mod complex – 30 min 97163 $77.50 Physical therapy evaluation High complex – 45 min 97164 $64.41 Physical therapy re-evaluation Est Plan Care – 20 min 97165 $78.31 Occupational therapy evaluation Low complex – 30 min 97166 $78.31 Occupational therapy evaluation Mod complex – 45 min 97167 $78.31 Occupational therapy evaluation High complex – 60 min 97168 $64.41 Occupational therapy re-evaluation Est Plan Care – 30 min
Modalities—Supervised 97010 $5.25 Application of a modality to one or more areas; hot or cold
packs
97012 $12.63 Application of a modality to one or more areas; traction,
mechanical
97014 $15.62 Application of a modality to one or more areas; electrical
stimulation (unattended)
97016 $13.04 Application of a modality to one or more areas;
vasopneumatic devices
97018 $6.47 Application of a modality to one or more areas; paraffin
bath
97022 $13.32 Application of a modality to one or more areas; whirlpool 97024 $5.74 Application of a modality to one or more areas; diathermy
(e.g., microwave)
97026 $5.24 Application of a modality to one or more areas; infrared 97028 $6.51 Application of a modality to one or more areas; ultraviolet
Modalities—Constant Attendance 97032 $14.68 Application of a modality to one or more areas; electrical
stimulation (manual), each 15 minutes
97033 $15.01 Application of a modality to one or more areas;
iontophoresis, each 15 minutes
97034 $14.68 Application of a modality to one or more areas; contrast
baths, each 15 minutes
97035 $14.68 Application of a modality to one or more areas;
ultrasound, each 15 minutes
97036 $27.68 Application of a modality to one or more areas; Hubbard
tank, each 15 minutes
97039 $18.06 Unlisted modality (specify type and time if constant
attendance)
Therapeutic Procedures 97110 $22.67 Therapeutic procedure, one or more areas, each 15
minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility
97112 $26.07 Therapeutic procedure, one or more areas, each 15
minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities
97113 $28.55 Therapeutic procedure, one or more areas, each 15
minutes; aquatic therapy with therapeutic exercises
97116 $22.67 Therapeutic procedure, one or more areas, each 15
minutes; gait training (includes stair climbing)
97124 $23.72 Therapeutic procedure, one or more areas, each 15
minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)
97139 $19.82 Unlisted therapeutic procedure (specify) (each 15 minutes) 97140 $20.83 Manual therapy techniques (e.g.,
mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes
97150 $25.56 Therapeutic procedure(s), group (two or more individuals)
(services delivered under an outpatient plan of care) (maximum one unit per visit )
5
Final Adoption
Date Published in Mass Register: June 6, 2025
101 CMR 339.00: RATES FOR RESTORATIVE SERVICES
Service Allowable Fee Service Description Code 97530 $28.65 Therapeutic activities, direct (one-on-one) patient contact
(use of dynamic activities to improve functional performance), each 15 minutes
97532 $18.06 Development of cognitive skills to improve attention,
memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes
97533 $49.38 Sensory integrative techniques to enhance sensory
processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes
97535 $25.38 Self-care/home management training (e.g., activities
of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes
97537 $24.49 Community/work reintegration training (e.g., shopping,
transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment) direct one-on-one contact, each 15 minutes
97542 $24.49 Wheelchair management (e.g., assessment, fitting,
training), each 15 minutes
97545 $117.41 Work hardening/conditioning; initial two hours 97546 $58.70 Work hardening/conditioning; each additional hour (list
separately in addition to code for primary procedure) (use in conjunction with 97545)
Active Wound Care Management 97597 $79.74 Debridement (e.g., high pressure waterjet with/without
suction, sharp selective debridement with scissors, scalpel and forceps), open wound (e.g., fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; first 20 sq cm or less
97598 $58.90 Debridement (e.g., high pressure waterjet with/without
suction, sharp selective debridement with scissors, scalpel and forceps), open wound (e.g., fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when performed and instruction(s) for ongoing care, per session, total wound(s) surface area; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)
97602 IC Removal of devitalized tissue from wound(s), non-
selective debridement, without anesthesia (e.g., wet-to- moist dressings, enzymatic, abrasion), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session
97605 $33.53 Negative pressure wound therapy (e.g., vacuum assisted
drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters
97606 $39.90 Negative pressure wound therapy (e.g., vacuum assisted
drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per
6
Final Adoption
Date Published in Mass Register: June 6, 2025
101 CMR 339.00: RATES FOR RESTORATIVE SERVICES
Service Allowable Fee Service Description Code
session; total wound(s) surface area greater than 50 square centimeters
Tests and Measurements 97750 $26.46 Physical performance test or measurement (e.g.,
musculoskeletal, functional capacity), with written report, each 15 minutes
97755 $29.50 Assistive technology assessment (e.g., to restore, augment
or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes
Orthotic Management and Prosthetic Management 97760 $37.43 Orthotic(s) management and training (including
assessment and fitting when not otherwise reported), upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes
97761 $32.57 Prosthetic training, upper and/or lower extremity(s), each
15 minutes
97762 $18.06 Checkout for orthotic/prosthetic use, established patient,
each 15 minutes
Other Procedures 97799 $19.82 Unlisted physical medicine/rehabilitation service or
procedure (each 15 minutes, maximum six units per visit)
Evaluation and Management—Office or Other Outpatient Services 99203 $85.74 Office or other outpatient visit for the evaluation
and management of a new patient, which requires these three key components: - a detailed history; - a detailed examination; and - medical decision making of low complexity
99205 $168.54 Office or other outpatient visit for the evaluation and
management of a new patient, which requires these three key components (written report required): - a comprehensive history; - a comprehensive examination; and - medical decision making of high complexity
99212 $43.92 Office or other outpatient visit for the evaluation and
management of an established patient, which requires at least two of these three key components: - a problem focused history; - a problem focused examination; and - straightforward medical decision making
99214 $98.65 Office or other outpatient visit for the evaluation and
management of an established patient, which requires at least two of these three key components (written report required): - a detailed history; - a detailed examination; and - medical decision making of moderate complexity
99215 $138.48 Office or other outpatient visit for the evaluation and
management of an established patient, which requires at least two of these three key components (written report required): - a comprehensive history; - a comprehensive examination; and - medical decision making of high complexity
Caregiver Training Codes
Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or
97550 $40.44 community (e.g., activities of daily living [ADLs],
instrumental ADLs [iADLs], transfers, mobility, communication, swallowing, feeding, problem solving,
7
Final Adoption
Date Published in Mass Register: June 6, 2025
101 CMR 339.00: RATES FOR RESTORATIVE SERVICES
Service Allowable Fee Service Description Code
safety practices) (without the patient present), face to face; initial 30 minutes Caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (e.g., activities of daily living [ADLs], instrumental ADLs [iADLs], transfers, mobility,
97551 $20.02 communication, swallowing, feeding, problem solving,
safety practices) (without the patient present), face to face; each additional 15 minutes
(Use 97551 in conjunction with 97550) Group caregiver training in strategies and techniques to facilitate the patient's functional performance in the home or community (e.g., activities of daily living [ADLs],
97552 $17.51 instrumental ADLs [iADLs], transfers, mobility,
communication, swallowing, feeding, problem solving, safety practices) (without the patient present), face to face with multiple sets of caregivers
Rehabilitation Center Physical Therapist $64.41hr. Rehabilitation Center Occupational Therapist $64.41hr. Rehabilitation Center Speech Therapist $64.41hr. Restorative Physical Therapy office visit $64.41hr. Restorative Occupational Therapy office visit $64.41hr. Restorative Speech Therapy office visit $64.41hr. Restorative Physical Therapy out-of-office visit $74.07hr. Restorative Occupational Therapy out-of-office visit $74.07hr. Restorative Speech Therapy out-of-office visit $74.07hr.