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Nebraska 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 $186 · 10th–90th $95–$3470%10%10th90th$186Professionalmedian $123 · 10th–90th $63–$3310%10%10th90th$123$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
$95.50 / $186.21 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $114.82 / $331.13
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $281.84 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $151.36 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $213.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $181.97 / $257.04
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $151.36 / $223.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $213.80
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $109.65 / $229.09
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $87.10 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $83.18 / $204.17