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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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.78 / $117.22 / $250.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.90 / $76.88 / $105.19
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.59 / $120.30 / $176.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.59 / $105.59 / $124.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $65.00 / $88.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.99 / $86.23 / $140.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.76 / $94.58 / $225.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.85 / $85.54 / $633.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.99 / $77.33 / $124.09