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97161 · North Carolina · every payer

What every payer pays for 97161 in North Carolina

Across 11 commercial payers in North Carolina, the middle payer's median for 97161 (physical therapy evaluation, level 1 of 3) is $83.66 per session. North Carolina Medicaid's fee-for-service rate, $66.11 per session, is 21% below that commercial median.

Updated 2026-10-08October 2026 filesSources: state fee schedule, CMS, price-transparency files

Commercial median
$83.66per session
North Carolina Medicaid
$66.11
Medicare
$94.66
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Payer mix

97161 in North Carolina, by payer type

Medicare's physician fee schedule pays $94.66 in North Carolina.

North Carolina Medicaid$66.11
Medicare$94.66
Commercial (11 payers)$83.66
UnitedHealthcare$79.65
Aetna$83.84
per session. Commercial = median of payer medians, October 2026 files.
By payer

Each payer's 97161 rate in North Carolina

PayerMedianPer hourRates (n)
UnitedHealthcareCommercial$79.65 per session—153
AetnaCommercial$83.84 per session—86
See every payer's 97161 rate in North Carolina

Each commercial payer's median, p25–p75 and n, with Medicaid plan and Medicare Advantage rows. 7-day free trial.

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FAQ

Frequently asked questions

What do commercial payers pay for 97161 in North Carolina?

The median of 11 payers' medians is $83.66 per session, from 351 published rates in the October 2026 files.

How does North Carolina Medicaid compare with commercial insurance for 97161?

North Carolina Medicaid pays $66.11 per session, 21% below the commercial median.

What does Medicare pay for 97161 in North Carolina?

$94.66 on the RVU26B physician fee schedule (non-facility).

What does UnitedHealthcare pay for 97161 in North Carolina?

UnitedHealthcare's median is $79.65 per session, from 153 rates and 512 providers.

What does Aetna pay for 97161 in North Carolina?

Aetna's median is $83.84 per session, from 86 rates and 1139 providers.