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Iowa 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 $74 · 10th–90th $43–$2240%10%20%10th90th$74Professionalmedian $62 · 10th–90th $40–$2000%5%10%10th90th$62$50.0$100.0$200.0

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
$42.66 / $67.61 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $60.26 / $223.87
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$37.15 / $45.71 / $69.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $74.13 / $104.71
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $89.13 / $165.96
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $81.28 / $316.23
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $75.86 / $181.97
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $104.71 / $204.17
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $87.10 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $56.23 / $112.20
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $102.33