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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
$38.90 / $52.48 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $53.70 / $53.70
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $67.61 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $58.88 / $114.82
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $34.67 / $81.28
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $74.13 / $114.82
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $56.23 / $56.23
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $57.54 / $158.49
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $43.65 / $177.83
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.31 / $67.61 / $489.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $61.66 / $87.10