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Michigan 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 $66 · 10th–90th $52–$1860%20%40%10th90th$66Professionalmedian $52 · 10th–90th $37–$1020%10%10th90th$52$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
$52.48 / $56.23 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $52.48 / $112.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $93.33 / $117.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $60.26 / $60.26
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $79.43
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $66.07 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $58.88 / $158.49
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $54.95 / $158.49
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $54.95 / $112.20
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $48.98 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $53.70 / $83.18