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Arkansas rates for HCPCS 97161

Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $109.65 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $93.33 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $102.33 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $134.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $75.86 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $87.10 / $131.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $97.72 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $77.62 / $112.20