go back

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.

Facilitymedian $200 · 10th–90th $87–$6030%20%10th90th$200Professionalmedian $76 · 10th–90th $55–$2000%10%20%10th90th$76$1.0$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $199.53 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $74.13 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $60.26 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $72.44 / $100.00
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $74.13 / $154.88
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $0.79 / $147.91
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $97.72 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $10.00 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $87.10 / $141.25