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Nationwide rates for HCPCS 97162

Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family.

Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $162.18 / $389.05	Facility		$70.79	$162.18	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $229.09	Professional		$57.54	$83.18	$229.09
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	25	$120.23	$120.23	$120.23
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $57.54 / $57.54 / $144.54	Professional	CQ	$57.54	$57.54	$144.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $95.50 / $239.88	Facility		$77.62	$95.50	$239.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $144.54	Professional		$58.88	$75.86	$144.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $79.43 / $316.23	Facility		$58.88	$79.43	$316.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $162.18	Professional		$63.10	$85.11	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $97.72 / $107.15	Facility		$77.62	$97.72	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $81.28 / $123.03	Professional		$64.57	$81.28	$123.03

Nationwide rates for HCPCS 97162

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