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Nationwide rates for HCPCS 97164

Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family.

Facilitymedian $95 · 10th–90th $48–$2630%10%10th90th$95Professionalmedian $56 · 10th–90th $38–$1480%10%20%10th90th$56$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $100.00 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $53.70 / $144.54
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$45.71 / $69.18 / $69.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $95.50 / $239.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $57.54 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $79.43 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $57.54 / $112.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $74.13 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $54.95 / $104.71

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