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Physical Therapy Evaluation, Moderate Complexity

California rates for HCPCS 97162

This is an initial evaluation by a physical therapist to assess a person's condition, movement, and physical function in order to build a treatment plan. It reflects a moderate level of clinical complexity, more involved than the most straightforward evaluations but less involved than the most complex cases.

Rates data updated July 2026.

Facilitymedian $102 · 10th–90th $76$4370%10%10th90th$102Professionalmedian $81 · 10th–90th $58$3310%10%10th90th$81$10.0$50.0$200.0$1.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$245.47
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$79.43
Typical High
$354.81
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$87.10
Typical High
$131.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$239.88
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$107.15
Typical High
$245.47
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$194.98
Typical High
$269.15
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$72.44
Typical High
$316.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$87.10
Typical High
$173.78
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$83.18
Typical High
$151.36
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$190.55
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$630.96
Typical High
$630.96
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$134.90
Typical High
$831.76
Molina
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$141.25
Optum
Setting
Professional
Modifier
Global
Typical Low
$30.90
Median
$39.81
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$104.71
Typical High
$162.18
Providence
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$87.10
Typical High
$186.21
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$97.72
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$194.98