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Wisconsin 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 $78 · 10th–90th $54–$2190%10%20%10th90th$78Professionalmedian $60 · 10th–90th $43–$1740%10%10th90th$60$10.0$20.0$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
$53.70 / $63.10 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $53.70 / $147.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $56.23 / $177.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $87.10
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $66.07
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $190.55 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $97.72 / $208.93
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $66.07 / $141.25
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $131.83 / $194.98
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $83.18 / $234.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $79.43 / $165.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $147.91 / $218.78
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $125.89 / $436.52
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $295.12 / $436.52
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $158.49 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $83.18 / $158.49