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Pennsylvania rates for HCPCS 97168

Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and A revised plan of care. A formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required. Typically, 30 minutes are spent face-to-face with the patient and/or family.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.13 / $47.31 / $120.15
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.64 / $68.11 / $109.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.32 / $62.28 / $108.95
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $94.00
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.60 / $56.68 / $82.55
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.07 / $49.28 / $124.54
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.00 / $67.05 / $144.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.77 / $62.28 / $101.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.95 / $67.59 / $71.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.67 / $61.92 / $91.97