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Tennessee 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 $112 · 10th–90th $65–$3240%10%10th90th$112Professionalmedian $81 · 10th–90th $56–$1660%10%10th90th$81$50.0$100.0$200.0$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
$64.57 / $107.15 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $165.96
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $67.61 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $85.11 / $147.91
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $630.96 / $630.96
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $831.76 / $831.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $77.62 / $100.00