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Kentucky 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 $46 · 10th–90th $41–$790%20%40%10th90th$46Professionalmedian $47 · 10th–90th $28–$950%10%10th90th$47$20.0$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
$40.74 / $54.95 / $100.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $48.98 / $114.82
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $40.74 / $60.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $35.48 / $51.29
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $77.62 / $95.50
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $75.86 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $69.18 / $323.59
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $51.29 / $74.13