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Hawaii 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
$219.30 / $219.30 / $219.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.96 / $91.51 / $119.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.61 / $228.61 / $228.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.78 / $93.99 / $130.54
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.08 / $108.33 / $116.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.43 / $114.87 / $130.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.93 / $112.34 / $140.18
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.53 / $120.83 / $184.94