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