go back

Texas 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
$54.95 / $131.83 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $77.62 / $208.93
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$120.23 / $120.23 / $120.23
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$57.54 / $57.54 / $57.54
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $93.33 / $125.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $218.78 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $83.18 / $83.18
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $120.23 / $218.78
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $109.65 / $154.88
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $97.72 / $97.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $64.57 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $77.62 / $114.82
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $123.03 / $831.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $91.20 / $234.42
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $79.43 / $181.97
Moda Health
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$120.23 / $120.23 / $120.23
Moda Health
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$57.54 / $57.54 / $57.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $128.82
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $245.47 / $263.03
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $100.00 / $354.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $89.13 / $154.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $77.62 / $117.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $77.62 / $107.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $74.13 / $109.65
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $95.50 / $97.72