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Georgia 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 $26 · 10th–90th $18–$340%10%10th90th$26Professionalmedian $16 · 10th–90th $13–$280%10%20%10th90th$16$1.0$5.0$20.0$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
Facility
Modifier
Typical Low / Median / Typical High
$14.13 / $14.13 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $23.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $23.44 / $35.48
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $25.70 / $33.88
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $28.18 / $47.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $26.92 / $42.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $21.38 / $29.51
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $26.30 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $23.44 / $38.90