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Texas 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 $107 · 10th–90th $44–$3550%5%10th90th$107Professionalmedian $54 · 10th–90th $37–$980%20%10th90th$54$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
$42.66 / $109.65 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $51.29 / $112.20
Aetna
Facility/Professional
Professional
Modifier
CQ
Typical Low / Median / Typical High
$37.15 / $37.15 / $37.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $147.91 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $56.23 / $56.23
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $107.15 / $147.91
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $104.71
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $66.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $85.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $46.77 / $81.28
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $436.52
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $95.50 / $575.44
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $66.07 / $134.90
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $53.70 / $120.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $114.82
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $67.61 / $251.19
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$39.81 / $64.57 / $104.71
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $46.77 / $81.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $53.70 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $51.29 / $75.86
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $67.61 / $67.61