# CPT 97164: Re-evaluation of physical therapy established plan of care

Medicare CPT 97164 pays $67.47 in a non-facility setting and $67.47 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $62.36 in Arkansas to $85.63 in Alaska, a 37% spread.

Web page: https://www.med-reveal.com/rates/97164-cpt-fee-schedule
Section: Rehabilitation and Therapy

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $67.47 |
| National facility | $67.47 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $85.63 | $85.63 |
| District of Columbia | $75.48 | $75.48 |
| California | $74.89 | $74.89 |
| New Jersey | $73.57 | $73.57 |
| Washington | $73.32 | $73.32 |
| New York | $73.16 | $73.16 |
| Massachusetts | $72.66 | $72.66 |
| Hawaii | $72.13 | $72.13 |
| Connecticut | $70.88 | $70.88 |
| Colorado | $70.03 | $70.03 |
| Oregon | $69.51 | $69.51 |
| Maryland | $69.40 | $69.40 |
| Rhode Island | $69.20 | $69.20 |
| New Hampshire | $68.87 | $68.87 |
| Minnesota | $68.25 | $68.25 |
| Florida | $67.90 | $67.90 |
| Puerto Rico | $67.85 | $67.85 |
| Virgin Islands | $67.85 | $67.85 |
| Montana | $67.47 | $67.47 |
| Nevada | $67.45 | $67.45 |
| Wyoming | $67.38 | $67.38 |
| North Dakota | $67.27 | $67.27 |
| South Dakota | $67.25 | $67.25 |
| Delaware | $67.18 | $67.18 |
| Texas | $67.08 | $67.08 |
| Pennsylvania | $67.07 | $67.07 |
| Vermont | $66.95 | $66.95 |
| Virginia | $66.78 | $66.78 |
| Illinois | $66.70 | $66.70 |
| Arizona | $66.33 | $66.33 |
| Georgia | $65.97 | $65.97 |
| Maine | $65.79 | $65.79 |
| Wisconsin | $65.77 | $65.77 |
| Michigan | $65.47 | $65.47 |
| Utah | $65.33 | $65.33 |
| North Carolina | $65.00 | $65.00 |
| South Carolina | $64.75 | $64.75 |
| Indiana | $64.74 | $64.74 |
| New Mexico | $64.63 | $64.63 |
| Missouri | $64.58 | $64.58 |
| Nebraska | $64.56 | $64.56 |
| Idaho | $64.49 | $64.49 |
| Louisiana | $64.44 | $64.44 |
| Ohio | $64.42 | $64.42 |
| Iowa | $64.29 | $64.29 |
| Tennessee | $64.12 | $64.12 |
| Kansas | $63.94 | $63.94 |
| Oklahoma | $63.64 | $63.64 |
| Kentucky | $63.55 | $63.55 |
| West Virginia | $63.02 | $63.02 |
| Alabama | $62.94 | $62.94 |
| Mississippi | $62.51 | $62.51 |
| Arkansas | $62.36 | $62.36 |

## Related codes

- 97161: Physical therapy evaluation, low complexity — https://www.med-reveal.com/rates/97161-cpt-fee-schedule
- 97162: Physical therapy evaluation, moderate complexity — https://www.med-reveal.com/rates/97162-cpt-fee-schedule
- 97163: Physical therapy evaluation, high complexity — https://www.med-reveal.com/rates/97163-cpt-fee-schedule
- 97750: Physical performance test or measurement, with written report — https://www.med-reveal.com/rates/97750-cpt-fee-schedule
- 97755: Assistive technology assessment, with written report — https://www.med-reveal.com/rates/97755-cpt-fee-schedule

Commercial negotiated rates for 97164 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules