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New Mexico 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
$74.48 / $125.17 / $143.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.89 / $79.64 / $310.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $660.08 / $1,233.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.98 / $70.81 / $100.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $70.00 / $80.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.71 / $91.06 / $143.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $75.00 / $153.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65.00 / $87.58 / $114.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.71 / $91.06 / $143.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.47 / $87.70 / $111.83