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Ohio 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 $30 · 10th–90th $13–$740%20%10th90th$30Professionalmedian $17 · 10th–90th $13–$300%10%10th90th$17$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
$12.02 / $42.66 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $22.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $24.55 / $41.69
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $22.91 / $28.18
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.62 / $22.39 / $32.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.60 / $25.12 / $41.69
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $26.30 / $41.69
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.05 / $22.91 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $20.42 / $27.54