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Tennessee 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
$64.57 / $144.54 / $295.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $83.18 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $138.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $79.43 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $67.61 / $100.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $89.13 / $144.54
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $630.96 / $630.96
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $630.96 / $831.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $77.62 / $97.72