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Washington, DC 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
$77.62 / $239.88 / $2,754.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $77.62 / $154.88
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $151.36 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $77.62 / $269.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $169.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $107.15 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $97.72 / $223.87