go back

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
$70.79 / $112.20 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $112.20 / $331.13
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$151.36 / $208.93 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $57.54 / $147.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $104.71 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $70.79 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $81.28 / $186.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $97.72 / $223.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $83.18 / $234.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $77.62 / $123.03