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Colorado 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
$87.57 / $148.00 / $350.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.29 / $73.36 / $127.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.00 / $70.00 / $70.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $70.00 / $104.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.50 / $65.00 / $80.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.43 / $80.01 / $110.98
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.87 / $95.27 / $152.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.62 / $133.88 / $199.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.61 / $87.70 / $109.44