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Washington, DC 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)

Professionalmedian $15 · 10th–90th $13–$200%20%10th90th$15$10.0$20.0$50.0$100.0

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
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $19.95
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $20.42 / $23.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $32.36 / $50.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $18.62 / $25.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $25.70 / $47.86