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Idaho 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
$95.75 / $113.37 / $188.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $86.97 / $166.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.00 / $75.00 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.14 / $95.05 / $109.09
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.70 / $100.03 / $190.40
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.77 / $161.72 / $196.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $162.75
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.25 / $150.30 / $223.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.60 / $107.76 / $144.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.61 / $87.70 / $90.18