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Florida 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
$50.12 / $158.49 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $81.28 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.67 / $54.95 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $72.44 / $117.49
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.88 / $47.86 / $64.57
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $67.61 / $81.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $83.18 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $63.10 / $100.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $109.65