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Oklahoma 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
$57.00 / $69.37 / $129.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.29 / $69.37 / $78.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.47 / $94.36 / $141.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.63 / $96.25 / $132.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $65.00 / $105.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.81 / $81.06 / $111.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.43 / $78.41 / $225.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.33 / $78.93 / $130.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.33 / $74.55 / $109.44