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Ohio 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 $72 · 10th–90th $41–$1700%10%10th90th$72Professionalmedian $54 · 10th–90th $37–$1200%10%10th90th$54$1.0$5.0$20.0$100.0$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
$40.74 / $70.79 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $50.12 / $138.04
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $60.26 / $102.33
Aultcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $51.29 / $128.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$63.10 / $72.44 / $87.10
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $70.79 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $109.65 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $107.15
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $109.65 / $288.40
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $50.12 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $53.70
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $74.13 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $60.26 / $74.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $51.29 / $74.13