CPT 97150 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | • 11 - Office • 49 - Independent Clinic |
| Common Modifiers | • GP - Services delivered under an outpatient physical therapy plan of care • None • CQ - PT services by assistant |
| Complexity Level | Low |
National average reimbursement for CPT 97150 by major payers:
$26.03
$19.06
$17.70
$19.81
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 97150 | ||||||
United | 97150 | $12.22 | 1275786568 - ADNAN SHARIFF DPM PLLC | 263562113 - (FL) ADNAN SHARIFF, INC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $18.12 | 1538128020 - ROBERT GOECKER | 581728803 - NOVANT MEDICAL GROUP INC | NC | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $10.97 | 1417989302 - LAWRENCE HANDLER | 133755487 | FL | Podiatrist (213E00000X) |
United | 97150 | $10.88 | 1508851692 - SANDRA GOTMAN | 650429853 | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $43.16 | 1285876946 - FAIZ AHMAD | 581537752 - EMORY UNIVERSITY | FL | Neurological Surgery Physician (207T00000X) |
United | 97150 | $11.26 | 1275822256 - NISHA KRISHNAN | 471105876 - (FL) BEVERLY HILLS FOOT AND ANKLE PA | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $11.47 | 1285634741 - LARRY SEMER | 10962884 | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $12.22 | 1558304279 - DR. PAMELA KIRBY PA, DR. PAMELA KIRBY PA | 593418264 - (FL) DR PAMELA KIRBY PA | FL | Podiatrist (213E00000X) |
United | 97150 | $13.38 | 1861586455 - HELDO GOMEZ | 650233502 - (FL) HELDO GOMEZ, M.D., P.A. | FL | Neurological Surgery Physician (207T00000X) |
United | 97150 | $19.73 | 1760970081 - MORGAN GARCIA | 364600607 | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $10.14 | 1346248028 - BRIAN MASON | 461243081 | IL | Neurological Surgery Physician (207T00000X) |
United | 97150 | $13.14 | 1700840667 - ROBERT YANT | 593502544 - (FL) PODIATRY ASSOCIATES OF FLORIDA INC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $11.47 | 1083623771 - ALLEN SATER | 650396091 - (FL) ALLEN SATER DPM PA | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 97150 | $16.71 | 1164737490 - MOHAN EDUPUGANTI | 452867352 - INTEGRIS CARDIOVASCULAR PHYSICIANS LLC | MO | Interventional Cardiology Physician (207RI0011X) |
United | 97150 | $12.93 | 1346642501 - ABRAHAM ALVARADO-GONZALEZ | 264800380 | FL | Neurological Surgery Physician (207T00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 97150 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97150 code is part of the Medicine Services and Procedures services used for Physical Medicine and Rehabilitation Evaluations. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 97150 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 97140-CPT | Low | Manual Therapy Techniques (Eg, Mobilization/ Manipulation, Manual Lymphatic Drainage, Manual Traction), 1 Or More Regions, Each 15 Minutes |
| 97150-CPT | Low | Therapeutic Procedure(S), Group (2 Or More Individuals) |
| 97151-CPT | Low | Behavior Identification Assessment Admini- Stered By A Physician Or Other Qualified Health Care Professional Each 15 Minutes Of The Physi- Cians Or Other Qualified Health Care Profession- Als Time Face-To-Face With Patient And/Or Guar- Dian(S)/Caregiver(S) Administering Assessments Anddiscussing Findings And Recommendations And Non- Face-To-Face Analyzing Past Data Scoring/Inter- Preting The Assessment And Preparing The Report/ Treatment Plan |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97150. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97150 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 97150) and we'll show you how you compare in 15 minutes or less.