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Minnesota 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
$91.50 / $91.50 / $179.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.29 / $75.73 / $310.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.25 / $132.22 / $262.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.52 / $223.78 / $271.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.66 / $336.56 / $554.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.52 / $108.80 / $172.59
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.38 / $329.18 / $436.57
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.67 / $85.67 / $159.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.50 / $157.06 / $294.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.64 / $87.70 / $307.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.64 / $87.05 / $248.15