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Massachusetts 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 $21 · 10th–90th $11–$1350%10%10th90th$21Professionalmedian $21 · 10th–90th $13–$520%5%10%10th90th$21$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
$16.98 / $16.98 / $38.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $35.48
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $33.88 / $138.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $27.54 / $54.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $28.84 / $60.26
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.47 / $19.05 / $35.48
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $21.88 / $40.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $28.84 / $52.48
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $33.88 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $18.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $26.92 / $57.54