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Physical Therapy Evaluation, Moderate Complexity

Texas 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.

Facilitymedian $138 · 10th–90th $63$4170%5%10th90th$138Professionalmedian $81 · 10th–90th $58$1510%20%10th90th$81$20.0$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
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$131.83
Typical High
$407.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$75.86
Typical High
$173.78
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Aetna
Setting
Professional
Modifier
CQ · PT assistant
Typical Low
$57.54
Median
$57.54
Typical High
$144.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$218.78
Typical High
$416.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$83.18
Typical High
$83.18
Baylor Scott & White
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$120.23
Typical High
$218.78
Baylor Scott & White
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$109.65
Typical High
$151.36
Christus
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$100.00
Typical High
$100.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$64.57
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$77.62
Typical High
$117.49
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$158.49
Typical High
$831.76
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$95.50
Typical High
$190.55
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$79.43
Typical High
$173.78
Moda Health
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$120.23
Median
$120.23
Typical High
$120.23
Moda Health
Setting
Professional
Modifier
CQ · PT assistant
Typical Low
$57.54
Median
$57.54
Typical High
$144.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$128.82
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$245.47
Typical High
$263.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$97.72
Typical High
$363.08
Providence
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$91.20
Typical High
$151.36
Providence
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$77.62
Typical High
$117.49
United
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$74.13
Typical High
$112.20
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$97.72
Typical High
$97.72