Therapeutic exercise aimed at restoring balance, coordination, proprioception, posture, and movement control, billed in 15-minute units of direct contact.
- Medicare
- $32.73
- Work RVU
- 0.5
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Specific neuromuscular deficit (balance, proprioception, coordination)
- Objective measure (for example single-leg stance time, Berg score)
- Activities performed and minutes
- Direct one-on-one contact
- Progress toward functional goals
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
97112 is neuromuscular reeducation. It targets the nervous system's control of movement: balance, proprioception, coordination, and postural stability. It is timed in 15-minute units with direct one-on-one contact.
In ortho rehab, it fits single-leg balance work after ACL reconstruction, proprioceptive training after a lateral ankle sprain, scapular control work after shoulder surgery, and fall prevention after hip fracture. The note has to show why the work was neuromuscular. Straight strengthening is therapeutic exercise (97110), and functional tasks like transfers and lifting lean toward 97530.
Auditors flag 97112 when the documentation reads like a list of exercises with no deficit. State the impaired system (for example a positive single-leg stance test, poor joint position sense) and what was done to retrain it. Medicare applies the 8-minute rule across timed codes and needs GP or GO. When billed with other timed codes, keep the minutes for each distinct.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.5) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (0.98) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.5 |
| Practice expense RVU | 0.47 |
| Malpractice RVU | 0.01 |
| Total RVU | 0.98 |
| Medicare national rate | $32.73 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $32.73 |
Common denial reasons
The recurring reasons claims for CPT 97112 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Documentation describes strengthening only (should be 97110)
- No measurable neuromuscular deficit
- Units exceed documented minutes
- Missing GP or GO modifier
- Over therapy threshold without KX
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What is the difference between 97112 and 97110?
02Can 97112 be used after ACL reconstruction?
03Is 97112 timed?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe names the balance or proprioception deficit and the activities used to retrain it, which separates 97112 from general exercise in the note.
See how Mira captures CPT 97112 documentation