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Minnesota 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
$91.50 / $98.28 / $254.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.11 / $77.25 / $329.00
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$88.70 / $88.70 / $88.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.25 / $168.88 / $529.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.52 / $223.78 / $271.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.66 / $336.56 / $554.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.52 / $108.80 / $172.59
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.38 / $329.18 / $436.57
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.67 / $85.67 / $135.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$105.32 / $184.80 / $289.67
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.34 / $231.38 / $314.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.64 / $86.77 / $237.78