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Massachusetts 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 $145 · 10th–90th $42–$2400%10%20%10th90th$145Professionalmedian $65 · 10th–90th $37–$1740%10%10th90th$65$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$40.74 / $100.00 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $54.95 / $169.82
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $131.83 / $436.52
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $81.28 / $194.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $56.23 / $169.82
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $67.61 / $134.90
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $58.88 / $112.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $177.83
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $75.86 / $218.78
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $54.95 / $123.03
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $131.83 / $436.52
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $81.28 / $194.98
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $52.48 / $87.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $67.61 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $70.79 / $186.21