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Michigan 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 $17 · 10th–90th $16–$270%50%10th90th$17Professionalmedian $16 · 10th–90th $13–$260%10%20%10th90th$16$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
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $16.60 / $17.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.85 / $20.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $31.62 / $38.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $31.62 / $33.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.14 / $25.70 / $26.92
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$20.89 / $25.12 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $20.42 / $48.98
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$15.85 / $16.60 / $22.91
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $16.60 / $30.20
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $26.30 / $33.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $18.20 / $20.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $21.88 / $28.18