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Kentucky 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
$66.76 / $93.39 / $219.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $66.76 / $201.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.33 / $81.47 / $133.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.56 / $61.26 / $78.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.13 / $105.95 / $131.43
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.13 / $107.74 / $133.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $75.00 / $113.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.53 / $88.29 / $145.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $63.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.30 / $76.03 / $101.80