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Utah 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
$85.11 / $97.72 / $97.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $95.50 / $331.13
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 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $72.44 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $87.10 / $186.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $181.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $128.82 / $186.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $114.82 / $123.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $102.33 / $114.82
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $134.90 / $218.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $87.10 / $91.20