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Missouri 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
$71.48 / $116.00 / $289.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $73.63 / $310.00
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$57.12 / $57.12 / $57.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $58.31 / $148.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $68.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.54 / $81.09 / $142.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.66 / $102.86 / $228.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.68 / $77.66 / $158.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $76.23 / $126.77