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Delaware 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
$63.17 / $162.34 / $260.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.11 / $63.17 / $78.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $65.00 / $65.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.97 / $81.09 / $100.55
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.10 / $262.10 / $262.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.80 / $92.09 / $195.56