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Nevada 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
$93.20 / $187.48 / $465.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.29 / $66.06 / $322.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.84 / $75.00 / $133.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $60.00 / $70.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.87 / $79.98 / $100.55
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $88.37 / $132.80
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.80 / $98.19 / $147.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.95 / $87.70 / $128.32