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South Dakota 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
$91.50 / $91.50 / $115.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $71.55 / $120.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $93.39 / $107.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.55 / $120.00 / $267.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.31 / $103.87 / $199.23
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.70 / $141.25 / $170.69
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.35 / $125.45 / $201.19
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.79 / $146.13 / $196.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.31 / $80.37 / $167.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.20 / $137.30 / $161.50