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Arizona 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
$81.18 / $175.57 / $388.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.12 / $77.25 / $329.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.76 / $161.34 / $418.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.42 / $76.56 / $106.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $58.00 / $82.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.78 / $85.66 / $128.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.19 / $96.65 / $225.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.48 / $87.70 / $197.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.68 / $87.70 / $100.87