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Georgia 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 $52 · 10th–90th $46–$1450%20%40%10th90th$52Professionalmedian $58 · 10th–90th $39–$1150%10%10th90th$58$1.0$5.0$20.0$100.0$500.0

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
$45.71 / $48.98 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $54.95 / $114.82
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$69.18 / $69.18 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $57.54 / $95.50
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $91.20 / $112.20
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $74.13 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $70.79 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $54.95 / $107.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $77.62 / $147.91
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $91.20 / $97.72
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $56.23 / $95.50