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Missouri 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
$75.00 / $117.00 / $220.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $76.88 / $329.00
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$151.44 / $210.63 / $239.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.90 / $56.99 / $144.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $68.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.54 / $81.09 / $142.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $99.94 / $225.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.68 / $78.56 / $158.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $76.80 / $124.40