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West Virginia 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
$93.39 / $102.72 / $119.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.45 / $78.33 / $210.59
Aetna
Facility/Professional
Professional
Modifier
CQ
Low / Median / High Price
$89.46 / $89.46 / $89.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.97 / $103.27 / $151.75
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.97 / $101.17 / $213.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.06 / $113.06 / $113.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.14 / $85.64 / $134.53
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.85 / $151.87 / $155.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.86 / $77.95 / $134.26