Modifier 97 is an informational modifier used with therapy CPT codes to indicate services are rehabilitative — intended to restore skills or function lost due to illness, injury, or disability. It is appended alongside the discipline-specific therapy modifier (GP for physical therapy, GO for occupational therapy, GN for speech‑language pathology) when the therapy is rehabilitative in nature. CMS I/OCE guidance and CPT documentation treat modifier 97 as an indicator that a service was rehabilitative rather than habilitative.

Because modifier 97 is informational, it does not by itself change reimbursement rates. Authoritative sources describe the modifier as a marker payers may use for claims adjudication or tracking, but there is no indication in CMS or AAPC guidance that adding modifier 97 directly alters payment calculations. Providers should therefore expect claims to be paid according to the billed CPT code and applicable therapy discipline modifier; modifier 97 documents rehabilitative intent but does not automatically produce additional payment.

In practice, use modifier 97 when therapy services are provided to help a patient regain previously lost function. For example, therapeutic exercise (CPT 97110) after a stroke would be billed as 97110‑GP‑97 to show physical therapy with rehabilitative intent; speech‑language pathology evaluation after traumatic brain injury (CPT 92526) would be billed as 92526‑GN‑97. Always ensure clinical documentation supports rehabilitative intent and medical necessity, and review payer‑specific rules because commercial payers may have additional requirements beyond the informational use described by CMS and CPT.