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Vermont 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
$304.08 / $304.08 / $320.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $84.93 / $346.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.50 / $334.99 / $404.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.32 / $106.65 / $369.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.14 / $85.64 / $101.29
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.14 / $86.23 / $101.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.69 / $116.73 / $221.02