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Colorado 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
$87.57 / $129.65 / $360.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.29 / $70.73 / $96.34
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$57.12 / $57.12 / $57.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.00 / $70.00 / $70.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $70.00 / $104.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.50 / $65.00 / $80.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.43 / $80.01 / $110.98
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.87 / $95.27 / $152.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.62 / $131.88 / $186.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.61 / $87.70 / $109.44