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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 97162
  4. Cost Analysis

How Much Does Evaluation for physical therapy, typically 30 minutes Cost on Medicare?

Cost analysis for CPT 97162 — Evaluation for physical therapy, typically 30 minutes

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Average Medicare Payment

$74.10

2023 data

Total Payments (2023)

$97.2M

Services (2023)

1.3M

Price Change (2017–2023)

+23.4%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2017$60.04$69.6M1.2M—
2018$62.59$74.3M1.2M+4.2%
2019$63.34$79.1M1.2M+1.2%
2020$63.79$58.6M916.3K+0.7%
2021$76.21$86.8M1.1M+19.5%
2022$74.45$91.1M1.2M-2.3%
2023$74.10$97.2M1.3M-0.5%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $92.98 vs VI at $65.25.

StateAvg PaymentTotal PaymentsServicesProviders
AK$92.98$265.7K2.9K116
DC$82.46$177.2K2.1K67
NY$81.28$8.1M99.9K2.5K
NJ$81.17$5.3M65.8K2.0K
CA$79.43$12.3M155.2K3.4K
CT$79.28$920.7K11.6K371
MD$78.61$3.3M42.3K1.1K
MA$78.54$2.3M29.6K776
GU$77.82$15.2K1955
RI$77.15$335.8K4.4K139
DE$75.40$729.5K9.7K233
PR$75.37$68.4K90730
IL$75.19$4.2M55.7K1.7K
HI$75.07$416.3K5.5K172
VA$75.04$3.2M42.5K1.1K
NH$74.61$503.3K6.7K218
CO$74.25$1.9M25.8K858
WA$73.86$2.6M35.3K1.1K
PA$73.63$3.6M48.4K1.4K
NV$73.27$867.8K11.8K301
FL$73.01$6.2M84.6K1.7K
MN$72.74$1.1M14.9K511
SD$72.47$302.3K4.2K134
MI$72.46$2.1M29.2K1.0K
TX$72.26$4.2M58.3K1.6K
WY$72.14$513.7K7.1K191
MT$72.09$515.1K7.1K252
ND$71.96$124.1K1.7K59
ME$71.47$365.0K5.1K203
AZ$71.11$2.4M34.4K874
SC$70.87$1.8M25.4K659
OR$70.67$1.4M20.4K601
NC$70.55$2.5M35.7K1.0K
IN$70.46$1.6M23.4K647
UT$70.39$722.5K10.3K254
WI$70.06$1.5M21.1K791
OH$70.02$1.8M25.1K708
VT$69.66$213.0K3.1K101
NM$69.53$618.4K8.9K189
IA$69.50$1.3M18.6K553
LA$69.42$1.0M15.1K392
MO$69.36$1.2M17.8K532
NE$68.94$764.4K11.1K297
GA$68.84$2.6M37.6K1.0K
KY$68.70$1.2M16.9K492
AR$68.61$655.5K9.6K255
AL$68.47$1.2M17.2K449
OK$68.33$1.0M15.0K380
ID$68.33$662.5K9.7K315
WV$68.10$406.1K6.0K171
KS$67.88$997.8K14.7K403

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Spencer ClarkPhysical Therapist in Private PracticeUT$56.6K763$74.17
Ahson MahfoozPhysical Therapist in Private PracticeNY$54.4K600$90.74
Terri Bechtel GreenbergPhysical Therapist in Private PracticeCA$49.7K646$77.01
Darrel ElwellPhysical Therapist in Private PracticeNM$47.6K649$73.35
Stephanie SavinoPhysical Therapist in Private PracticeFL$39.5K525$75.24
Tami PeavyPhysical Therapist in Private PracticeCA$37.5K514$73.02
Khalid AttiaPhysical Therapist in Private PracticeNY$37.2K417$89.10
Mohamed AfifyPhysical Therapist in Private PracticeNY$36.3K405$89.57
Nicholas MalyPhysical Therapist in Private PracticeCA$35.7K435$82.18
Brinda MakadiaPhysical Therapist in Private PracticeNY$34.9K399$87.35
Tan NgoInternal MedicineCA$32.8K397$82.73
Mary Jean EndozoPhysical Therapist in Private PracticeNJ$31.5K352$89.56
Ehab BoulosPhysical Therapist in Private PracticeFL$30.1K414$72.81
Fernando OrlinoPhysical Therapist in Private PracticeCA$30.0K414$72.49
Marc GarberPhysical Therapist in Private PracticeCA$29.6K369$80.28
Wilfried KramerPhysical Therapist in Private PracticeCA$28.7K344$83.52
Zachary MichaelPhysical Therapist in Private PracticeTX$27.3K373$73.31
Britton MossPhysical Therapist in Private PracticeLA$27.3K368$74.29
Louis MoscardiPhysical Therapist in Private PracticeCA$27.1K337$80.27
Thomas DeguzmanPhysical Therapist in Private PracticeCA$26.6K331$80.39

🤔 Is Evaluation for physical therapy, typically 30 minutes Overpriced?

Based on the data, CPT 97162 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.

Costs have increased 23.4% since 2017. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.