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Virginia 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 $66 · 10th–90th $38–$1550%10%10th90th$66Professionalmedian $55 · 10th–90th $38–$1050%10%10th90th$55$50.0$200.0$1.0K$5.0K

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
$38.02 / $74.13 / $154.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$37.15 / $52.48 / $117.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $60.26 / $85.11
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $63.10 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $79.43 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $57.54 / $104.71
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $72.44 / $89.13
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $56.23 / $89.13
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $69.18 / $251.19
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $69.18 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $74.13 / $75.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $58.88 / $79.43