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Arkansas 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.

Facilitymedian $100 · 10th–90th $71–$1580%20%10th90th$100Professionalmedian $83 · 10th–90th $58–$1580%10%10th90th$83$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $85.11 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $83.18 / $158.49
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $75.86 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $79.43 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $97.72 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $79.43 / $114.82