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Illinois 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 $91 · 10th–90th $58–$2240%10%10th90th$91Professionalmedian $58 · 10th–90th $40–$1050%10%10th90th$58$50.0$100.0$200.0$500.0$1.0K

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
$54.95 / $87.10 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $52.48 / $117.49
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$45.71 / $45.71 / $69.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $70.79 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $51.29 / $107.15
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $97.72 / $144.54
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $85.11 / $89.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $74.13 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $56.23 / $100.00