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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.

Facilitymedian $257 · 10th–90th $126–$5250%10%10th90th$257Professionalmedian $141 · 10th–90th $71–$2880%5%10%10th90th$141$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $257.04 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $91.20 / $251.19
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $524.81 / $524.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $229.09 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $446.68 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $109.65 / $169.82
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $426.58 / $457.09
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $138.04
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $288.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $263.03 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $107.15 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $91.20 / $288.40