CPT 2026 · Physical Medicine

CPT 97546

Global ZZZ

Work hardening add-on

Effective 2026-04-01 Conv. factor $33.4009

No national RVU

Payment Methodology

Status Indicator

NCCI Partners

ZZZ

Global Period

No national RVU

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

CPT 97546 Billing & Documentation Guide

CPT code 97546 (Work hardening add-on) is classified under Physical Medicine with a global period indicator of ZZZ. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.

When billing 97546, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 97546 with related codes; this code has 10 PTP bundling relationships on file (see table below).

Payment Status & Global Period

CMS Status Indicator

Restricted coverage (special situations)

Global Period

ZZZ

Add-on code (global concept does not apply)

MUE Limit (Medically Unlikely Edits)

Max units per beneficiary per date of service

Rationale: Clinical: Data

Adjudication: Date of Service (Clinical)

Source: CMS NCCI MUE Practitioner Services, effective 2026-04-01.

Submitting more than 2 units of 97546 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.

NCCI Bundling Edits, CPT 97546

Procedure-to-procedure (PTP) edits. If you bill any of these codes with 97546 on the same date of service, review the modifier indicator and payer policy before submission.

Partner Code	Relationship	Modifier Allowed	Rationale
36591	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
36592	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
96523	Column 1 (primary), can be billed with modifier	No	CPT Manual or CMS manual coding instruction
G0151	Column 2 (secondary), bundled into primary	Yes	Standards of medical/surgical practice
G0157	Column 2 (secondary), bundled into primary	Yes	Standards of medical/surgical practice
G0159	Column 2 (secondary), bundled into primary	Yes	Standards of medical/surgical practice
M0005	Column 2 (secondary), bundled into primary	9	Standards of medical/surgical practice
M0006	Column 2 (secondary), bundled into primary	9	Standards of medical/surgical practice
M0007	Column 2 (secondary), bundled into primary	9	Standards of medical/surgical practice
M0008	Column 2 (secondary), bundled into primary	9	Standards of medical/surgical practice

Frequently Asked Questions, CPT 97546

What does CPT code 97546 mean? +

CPT code 97546 represents: Work hardening add-on. It's in the Physical Medicine category with a global period of ZZZ.

What is the Medicare reimbursement for CPT 97546? +

This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.

What modifiers can I use with CPT 97546? +

Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.

What bundling edits apply to CPT 97546? +

This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.