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Arizona rates for HCPCS 97163

Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.18 / $196.19 / $394.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.11 / $76.04 / $322.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.22 / $215.96 / $418.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.42 / $76.56 / $95.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $58.00 / $82.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.78 / $85.66 / $128.49
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.94 / $96.65 / $225.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.68 / $87.70 / $195.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.68 / $86.64 / $103.70