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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. 97164
  4. Cost Analysis

How Much Does Re-evaluation for physical therapy, typically 20 minutes Cost on Medicare?

Cost analysis for CPT 97164 — Re-evaluation for physical therapy, typically 20 minutes

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Average Medicare Payment

$53.22

2023 data

Total Payments (2023)

$23.1M

Services (2023)

430.5K

Price Change (2017–2023)

+25.4%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2017$42.43$18.9M446.5K—
2018$44.41$20.1M451.9K+4.7%
2019$45.07$22.3M492.6K+1.5%
2020$46.29$16.2M348.7K+2.7%
2021$54.22$21.9M403.0K+17.1%
2022$53.85$23.7M439.6K-0.7%
2023$53.22$23.1M430.5K-1.2%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.8x more than the cheapest for this procedure. AK averages $66.78 vs MI at $36.27.

StateAvg PaymentTotal PaymentsServicesProviders
AK$66.78$24.2K36217
DC$58.63$57.1K97424
NJ$58.48$2.1M35.5K662
CT$57.15$179.2K3.1K63
MD$56.85$2.1M36.7K557
NY$56.83$1.6M28.4K675
MA$56.30$830.1K14.7K333
CA$56.22$3.0M53.6K1.2K
VI$55.41$7.4K1332
HI$55.29$197.0K3.6K84
DE$54.34$212.9K3.9K83
PA$53.99$1.5M27.9K578
IL$53.85$493.1K9.2K202
VA$53.45$566.3K10.6K187
CO$53.28$650.2K12.2K259
PR$53.18$31.1K58422
RI$53.11$82.3K1.5K43
FL$53.11$992.5K18.7K343
MT$53.07$69.7K1.3K36
NH$52.93$75.4K1.4K31
MN$52.40$63.7K1.2K39
ND$52.30$10.8K2069
WA$52.24$369.8K7.1K210
ME$52.17$108.2K2.1K56
TX$51.88$1.7M32.0K510
AZ$51.45$1.2M22.4K490
IN$51.33$190.2K3.7K101
WI$50.99$100.0K2.0K60
OH$50.83$502.4K9.9K236
WY$50.79$80.5K1.6K40
OR$50.68$148.5K2.9K101
KS$50.64$141.8K2.8K60
SC$50.51$276.0K5.5K95
SD$50.47$8.5K1699
NE$50.39$128.6K2.6K63
UT$50.38$132.2K2.6K76
MO$50.32$286.2K5.7K102
IA$50.31$314.2K6.2K150
GA$50.03$209.7K4.2K88
VT$50.01$96.6K1.9K41
LA$49.87$274.7K5.5K98
NM$49.62$75.9K1.5K33
TN$49.57$305.3K6.2K140
WV$49.53$114.8K2.3K56
OK$49.28$72.0K1.5K42
AR$49.27$89.7K1.8K38
AL$49.11$122.7K2.5K61
KY$48.94$281.7K5.8K126
NC$48.39$473.1K9.8K203
MS$47.98$82.7K1.7K37
ID$47.69$84.8K1.8K49

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Gayle ReedPhysical Therapist in Private PracticeFL$55.1K1.0K$54.63
Adi HaliliPhysical Therapist in Private PracticeAZ$52.6K974$54.04
Frank CawleyPhysical Therapist in Private PracticePA$51.1K973$52.55
David BullockPhysical Therapist in Private PracticeMD$49.9K810$61.58
Carol FrazierPhysical Therapist in Private PracticeMD$44.7K792$56.48
William HoganPhysical Therapist in Private PracticeVT$27.4K547$50.15
Ariz MehtaPhysical Medicine and RehabilitationNJ$27.2K430$63.17
Brennon MonroePhysical Therapist in Private PracticeMD$27.1K435$62.26
Ryan LynchPhysical Therapist in Private PracticeMD$26.3K477$55.13
Michele DyogiPhysical Therapist in Private PracticeTX$26.0K496$52.47
Michael SmithPhysical Therapist in Private PracticeTN$25.9K510$50.83
Alina DawsonPhysical Therapist in Private PracticeVA$24.8K462$53.58
Filemon BautistaPhysical Therapist in Private PracticeTX$24.6K455$54.02
Larry BrimhallPhysical Therapist in Private PracticeAZ$24.2K453$53.47
Henry BusseyPhysical Therapist in Private PracticeTX$24.0K459$52.26
Arnan SissonPhysical Therapist in Private PracticeVA$23.9K445$53.80
Javier LealPhysical Therapist in Private PracticeTX$23.3K454$51.27
Michael HartPhysical Therapist in Private PracticeFL$23.1K495$46.76
Lisa RozoPhysical Therapist in Private PracticeCO$23.0K419$54.89
Andrea PallaisPhysical Therapist in Private PracticeTX$22.0K400$55.03

🤔 Is Re-evaluation for physical therapy, typically 20 minutes Overpriced?

Based on the data, CPT 97164 shows a 1.8x variation in pricing across states — moderate variation by Medicare standards.

Costs have increased 25.4% 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.