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Tennessee 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
$64.31 / $100.78 / $326.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.11 / $66.23 / $153.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.93 / $87.24 / $154.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $65.00 / $95.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.14 / $84.36 / $127.74
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.07 / $458.69 / $516.79
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.66 / $633.66 / $824.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.16 / $77.66 / $96.02