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New Mexico 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
$74.48 / $125.17 / $143.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.62 / $74.48 / $289.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $660.08 / $1,233.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.77 / $70.81 / $100.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $70.00 / $80.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.71 / $91.06 / $143.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $75.00 / $153.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $87.58 / $114.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.71 / $91.06 / $143.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.47 / $87.70 / $125.40