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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
$125.89 / $257.04 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $83.18 / $257.04
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$89.13 / $89.13 / $89.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $524.81 / $524.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $213.80 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $446.68 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $109.65 / $173.78
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $426.58 / $457.09
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $138.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.49 / $194.98 / $288.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $263.03 / $316.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $107.15 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $87.10 / $257.04