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Iowa 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
$63.74 / $121.10 / $234.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.51 / $95.07 / $332.00
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$60.14 / $60.14 / $60.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.00 / $65.00 / $113.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $107.08 / $153.25
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.55 / $128.46 / $184.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.01 / $125.66 / $230.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.04 / $85.18 / $236.51
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.10 / $141.25 / $201.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.48 / $151.19 / $213.27
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.87 / $246.90 / $691.32
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.04 / $128.68 / $178.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.43 / $82.70 / $147.31
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.20 / $126.20 / $148.50