What every payer pays for 97161 in Pennsylvania
Across 12 commercial payers in Pennsylvania, the middle payer's median for 97161 (physical therapy evaluation, level 1 of 3) is $83.06 per session. Pennsylvania Medicaid's fee-for-service rate, $63.61 per session, is 23% below that commercial median.
- Commercial median
- $83.06per session
- Pennsylvania Medicaid
- $63.61
- Medicare
- $94.07+
On this page
97161 in Pennsylvania, by payer type
Medicare's physician fee schedule pays $94.07–$100.74 in Pennsylvania across 2 localities.
Each payer's 97161 rate in Pennsylvania
Frequently asked questions
What do commercial payers pay for 97161 in Pennsylvania?
The median of 12 payers' medians is $83.06 per session, from 426 published rates in the October 2026 files.
How does Pennsylvania Medicaid compare with commercial insurance for 97161?
Pennsylvania Medicaid pays $63.61 per session, 23% below the commercial median.
What does Medicare pay for 97161 in Pennsylvania?
$94.07 to $100.74 on the RVU26B physician fee schedule (non-facility).
What does UnitedHealthcare pay for 97161 in Pennsylvania?
UnitedHealthcare's median is $76.45 per session, from 211 rates and 868 providers.
What does Horizon BCBS NJ pay for 97161 in Pennsylvania?
Horizon BCBS NJ's median is $78.12 per session, from 52 rates and 141 providers.