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Nationwide rates for HCPCS 97130

Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencing tasks), direct (one-on-one) patient contact; each additional 15 minutes (List separately in addition to code for primary procedure)

Facilitymedian $22 · 10th–90th $14–$440%10%20%10th90th$22Professionalmedian $17 · 10th–90th $13–$340%20%10th90th$17$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $28.18 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $23.99
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.90 / $33.11 / $33.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $21.88 / $40.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $56.23 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $22.39 / $47.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.42 / $23.44 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $23.44 / $46.77

See more rates by state

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