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Physical Therapy Evaluation, Moderate Complexity

Pennsylvania 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 $110 · 10th–90th $69$3550%20%10th90th$110Professionalmedian $78 · 10th–90th $56$2750%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
$69.18
Median
$109.65
Typical High
$354.81
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$75.86
Typical High
$309.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$93.33
Typical High
$169.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$162.18
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$95.50
Typical High
$162.18
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$131.83
Typical High
$134.90
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$112.20
Typical High
$165.96
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$239.88
Typical High
$416.87
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$85.11
Typical High
$87.10
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$109.65
Typical High
$354.81
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$74.13
Typical High
$144.54
Martin's Point
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$302.00
Typical High
$371.54
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$89.13
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$190.55
Typical High
$323.59
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$97.72
Typical High
$104.71
United
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$107.15
Typical High
$107.15
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$85.11
Typical High
$131.83