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Delaware 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
$63.17 / $162.34 / $656.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.11 / $63.17 / $78.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $65.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.97 / $81.09 / $100.55
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.10 / $262.10 / $262.10
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.41 / $82.41 / $82.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.06 / $92.09 / $195.56