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Physical Therapy Evaluation, Moderate Complexity

New York rates for HCPCS 97162

This is an initial evaluation by a physical therapist to assess a person's condition, movement, and physical function in order to build a treatment plan. It reflects a moderate level of clinical complexity, more involved than the most straightforward evaluations but less involved than the most complex cases.

Rates data updated July 2026.

Facilitymedian $145 · 10th–90th $60$3800%10%20%10th90th$145Professionalmedian $78 · 10th–90th $45$2690%10%20%10th90th$78$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$144.54
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$77.62
Typical High
$331.13
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$85.11
Typical High
$144.54
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Cigna
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$162.18
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$131.83
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$34.67
Median
$109.65
Typical High
$245.47
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$114.82
Typical High
$218.78
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$120.23
Typical High
$134.90
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$112.20
Typical High
$186.21
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$213.80
Median
$213.80
Typical High
$218.78
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$50,118.72
Median
$53,703.18
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$112.20
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$107.15
Typical High
$331.13
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$54.95
Typical High
$269.15
Univera
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$112.20
Typical High
$120.23
Univera
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$112.20
Typical High
$194.98