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Kentucky 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 $20 · 10th–90th $13–$350%20%10th90th$20Professionalmedian $16 · 10th–90th $13–$240%20%10th90th$16$10.0$20.0$50.0$100.0$200.0

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
$12.88 / $12.88 / $14.13
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $21.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $17.78 / $21.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $21.88 / $30.90
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $21.88 / $28.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.18 / $29.51 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $32.36 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $20.89 / $33.11