go back

California 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 $98 · 10th–90th $76–$3020%10%20%10th90th$98Professionalmedian $55 · 10th–90th $40–$2240%10%10th90th$55$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$51.29 / $154.88 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $53.70 / $223.87
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$45.71 / $45.71 / $69.18
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $60.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $95.50 / $239.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $173.78
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $186.21
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $50.12 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $117.49
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $72.44 / $114.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $75.86 / $131.83
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $436.52 / $436.52
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $95.50 / $575.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $97.72
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $39.81 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $72.44 / $112.20
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $125.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $60.26 / $134.90