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Texas 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 $18 · 10th–90th $13–$300%10%10th90th$18Professionalmedian $17 · 10th–90th $12–$250%10%10th90th$17$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 / $107.15 / $128.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $15.85 / $23.99
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20.89 / $39.81 / $87.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $17.38 / $23.44
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.20 / $57.54 / $57.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $16.60 / $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
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.18 / $17.78 / $26.92
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.23 / $16.98 / $32.36
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $36.31 / $54.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.88 / $17.78 / $27.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.79 / $17.38 / $42.66
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $24.55 / $24.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $19.95 / $33.11
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $21.38 / $25.70