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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
$50.62 / $138.03 / $287.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.89 / $65.55 / $103.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $55.00 / $70.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.89 / $73.50 / $105.75
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.99 / $40.00 / $56.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.90 / $55.43 / $74.18
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.03 / $106.60 / $147.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.16 / $62.09 / $100.32
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.65 / $83.65 / $83.65