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Ohio 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 $141 · 10th–90th $66–$2950%10%10th90th$141Professionalmedian $83 · 10th–90th $58–$1860%5%10%10th90th$83$1.0$5.0$20.0$100.0$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
$66.07 / $131.83 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $208.93
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $87.10 / $151.36
Aultcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $131.83 / $131.83
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $75.86 / $190.55
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $107.15 / $125.89
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $104.71 / $218.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $141.25 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $83.18 / $158.49
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $208.93 / $354.81
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $87.10 / $147.91
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $79.43
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $158.49
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $87.10 / $107.15
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $109.65