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Oregon 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
$91.20 / $229.09 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $77.62 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $104.71 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $102.33 / $263.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $204.17 / $251.19
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $107.15 / $239.88
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $162.18 / $239.88
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $181.97 / $199.53
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $97.72 / $190.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $131.83 / $251.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $223.87 / $407.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $123.03 / $263.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.15 / $107.15 / $154.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $87.10 / $204.17