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South Dakota 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 $158 · 10th–90th $74–$2090%20%10th90th$158Professionalmedian $68 · 10th–90th $43–$1200%10%10th90th$68$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
$81.28 / $158.49 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $64.57 / $112.20
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $83.18 / $91.20
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $89.13 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $74.13 / $75.86
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $70.79 / $134.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $60.26 / $134.90
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $95.50
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $123.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $97.72 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $56.23 / $134.90
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $95.50 / $112.20