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Connecticut 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
$73.63 / $271.00 / $384.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.62 / $70.86 / $95.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.47 / $211.30 / $361.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.09 / $79.64 / $104.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.27 / $171.27 / $171.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.53 / $83.82 / $101.29
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $89.00 / $171.00
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $114.31
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.90 / $49.89 / $269.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.76 / $89.24 / $121.96