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Missouri 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
$71.48 / $107.21 / $223.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $73.63 / $322.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.60 / $58.31 / $148.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $68.00 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.54 / $81.09 / $142.53
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.74 / $98.53 / $243.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $77.66 / $158.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.28 / $78.56 / $129.41