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North Carolina 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 $69 · 10th–90th $55–$1660%20%10th90th$69Professionalmedian $56 · 10th–90th $40–$1120%10%10th90th$56$50.0$100.0$200.0$500.0

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
$57.54 / $77.62 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $57.54 / $120.23
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $52.48 / $83.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $51.29 / $93.33
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $57.54 / $89.13
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $61.66 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $54.95 / $85.11
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $575.44 / $575.44