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Montana 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
$234.40 / $234.40 / $234.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.12 / $77.25 / $342.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.27 / $158.27 / $158.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.53 / $158.27 / $188.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.73 / $125.45 / $158.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.95 / $85.45 / $158.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.60 / $135.66 / $176.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.63 / $87.70 / $100.86