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Tennessee 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 $22 · 10th–90th $13–$1350%10%20%10th90th$22Professionalmedian $15 · 10th–90th $13–$230%20%10th90th$15$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
$12.88 / $12.88 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $20.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $22.91 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $54.95 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $18.62 / $38.02
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $169.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.39 / $23.44 / $38.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $22.39 / $31.62