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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
$114.82 / $144.54 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $81.28 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $741.31 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $70.79 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $75.86 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $95.50 / $144.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $141.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $85.11 / $128.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $97.72 / $144.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $87.10 / $125.89