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Nebraska 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
$98.41 / $158.57 / $185.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $98.41 / $310.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.33 / $293.74 / $568.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.32 / $149.94 / $210.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.10 / $113.10 / $129.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.67 / $137.80 / $229.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $141.25 / $225.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.02 / $82.52 / $219.70
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.10 / $141.91 / $193.15
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.34 / $146.75 / $229.43
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.88 / $190.17 / $211.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.68 / $82.52 / $200.61