go back

New Jersey 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
$57.60 / $196.04 / $873.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.74 / $60.59 / $99.14
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.81 / $332.98 / $475.20
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.93 / $98.46 / $205.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.65 / $163.65 / $163.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.89 / $86.23 / $130.44
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $55.00 / $110.00
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.67 / $73.73 / $116.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.12 / $85.76 / $109.24