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Kansas 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.

Facilitymedian $107 · 10th–90th $81–$2000%20%10th90th$107Professionalmedian $89 · 10th–90th $60–$1260%10%10th90th$89$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $107.15 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $79.43 / $112.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $162.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $85.11 / $141.25
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $95.50 / $223.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $85.11 / $630.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $97.72 / $144.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $77.62 / $120.23