go back

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
$81.28 / $194.98 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $95.50 / $269.15
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$85.11 / $85.11 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $109.65 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $77.62 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $57.54 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $93.33 / $151.36
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $97.72 / $223.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $87.10 / $199.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $69.18 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $85.11 / $117.49