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Indiana 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
$81.48 / $229.15 / $253.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.61 / $70.86 / $106.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.68 / $81.47 / $181.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.87 / $74.63 / $109.01
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.69 / $112.43 / $131.16
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.69 / $105.95 / $126.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $80.00 / $268.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.53 / $86.23 / $146.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.93 / $77.87 / $98.04