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New York 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 $129 · 10th–90th $41–$3800%10%10th90th$129Professionalmedian $54 · 10th–90th $36–$1480%20%10th90th$54$10.0$50.0$200.0$1.0K$5.0K$20.0K

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 / $131.83 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $53.70 / $169.82
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $75.86 / $102.33
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $186.21 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $43.65 / $85.11
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $75.86 / $173.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $79.43 / $151.36
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $81.28 / $91.20
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $77.62 / $128.82
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $112.20
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $77.62 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $74.13 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $44.67 / $173.78
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $77.62 / $81.28
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $77.62 / $134.90