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Vermont 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
$281.84 / $323.59 / $426.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $75.86 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $263.03 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $95.50 / $144.54
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $123.03 / $371.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $117.49 / $218.78