CPT 97162

Physical Therapy Evaluation Mod Complex 30 Mins

CPT 97162 pays $97.86 in a non-facility setting and $97.86 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $91.20 in Arkansas to $126.43 in Alaska, a 39% spread.

National non-facility rate

$97.86

Office and other outpatient settings

Facility rate
$97.86

Hospital and ASC settings

Highest state
$126.43

Alaska

Lowest state
$91.20

Arkansas · 39% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $97.86
CPT 97162 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $97.86, national facility $97.86.
StateRate compared visuallyNon-facilityFacility
Alaska
$126.43$126.43
District of Columbia
$108.88$108.88
California
$108.00$108.00
New Jersey
$106.35$106.35
Washington
$105.87$105.87
New York
$105.75$105.75
Massachusetts
$104.97$104.97
Hawaii
$104.04$104.04
Connecticut
$102.51$102.51
Colorado
$101.36$101.36
Oregon
$100.65$100.65
Maryland
$100.52$100.52
Rhode Island
$100.33$100.33
New Hampshire
$99.71$99.71
Minnesota
$98.97$98.97
Puerto Rico
$98.37$98.37
Virgin Islands
$98.37$98.37
Florida
$98.33$98.33
Montana
$97.86$97.86
Nevada
$97.85$97.85
Wyoming
$97.78$97.78
North Dakota
$97.67$97.67
South Dakota
$97.64$97.64
Delaware
$97.53$97.53
Pennsylvania
$97.41$97.41
Texas
$97.41$97.41
Vermont
$97.24$97.24
Virginia
$96.98$96.98
Illinois
$96.79$96.79
Arizona
$96.39$96.39
Georgia
$95.89$95.89
Wisconsin
$95.70$95.70
Maine
$95.69$95.69
Michigan
$95.19$95.19
Utah
$95.06$95.06
North Carolina
$94.66$94.66
Indiana
$94.33$94.33
South Carolina
$94.31$94.31
Nebraska
$94.11$94.11
New Mexico
$94.11$94.11
Missouri
$94.06$94.06
Idaho
$94.00$94.00
Louisiana
$93.87$93.87
Ohio
$93.86$93.86
Iowa
$93.75$93.75
Tennessee
$93.52$93.52
Kansas
$93.27$93.27
Oklahoma
$92.86$92.86
Kentucky
$92.72$92.72
West Virginia
$91.97$91.97
Alabama
$91.96$91.96
Mississippi
$91.37$91.37
Arkansas
$91.20$91.20

Billed by 1 specialties

Commercial rates for 97162

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates