PT Evaluation (Low Complexity) Cost in Alaska
Pt eval low complex 20 min
$126.43Alaska physician fee2026 Medicare office rate- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Alaska Medicare physician rate (2026)
+29.2% vs nationalSingle statewide locality.
Your ZIP in Alaska
Look up your ZIP code to see Alaska's adjusted rates, whether you are in Anchorage, Fairbanks, Juneau, the Mat-Su Valley, or a fly-in community off the road system.
What pt evaluation (low complexity) costs at hospitals near you
Everything above is a national average. The hospital you pick in Alaska moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.
National vs Alaska
Where Alaska ranks for this CPT
PT Evaluation (Low Complexity) and how Alaska is priced
Alaska stands apart in the Medicare fee schedule: it is a single statewide locality, but federal law sets a permanent 1.5 floor on its physician work adjustment, the highest geographic treatment in the country. Combined with elevated practice expense indices that reflect the real cost of running a clinic in a remote state, Alaska's Medicare-approved amounts are consistently the highest of any state. Every community from Anchorage to the smallest bush village prices off the same locality, so the premium applies statewide rather than only in the cities.
Anchorage holds most of the state's specialists, and Fairbanks and Juneau add regional capacity, but many Alaskans still fly to Anchorage or even Seattle for complex procedures. Travel and lodging can rival the medical bill itself for residents of remote communities, which makes planning ahead unusually important here. Tribal health facilities also play a large role in care delivery across much of the state.
This procedure: This is the initial physical therapy evaluation for straightforward cases: a low-complexity assessment where the PT reviews your history, examines movement, strength, and function, and builds your treatment plan. It applies when you have no significant complicating factors, for example a recent simple ankle sprain in an otherwise healthy person. The appointment usually runs 30 to 60 minutes and often includes the first treatment, which is billed separately on top.
What Is PT Evaluation (Low Complexity)?
This is the initial physical therapy evaluation for straightforward cases: a low-complexity assessment where the PT reviews your history, examines movement, strength, and function, and builds your treatment plan. It applies when you have no significant complicating factors, for example a recent simple ankle sprain in an otherwise healthy person. The appointment usually runs 30 to 60 minutes and often includes the first treatment, which is billed separately on top.
What Affects the Cost
- –The evaluation is a one-time charge at the start of care, usually priced above a standard treatment visit.
- –Treatment codes billed at the same first visit stack on top of the evaluation fee.
- –Complexity tiering matters: this low-complexity code is the least expensive of the three PT evaluation levels under many commercial fee schedules, though Medicare currently pays all three tiers the same.
- –Direct access rules let you start PT without a physician referral in most states, saving a doctor visit, but some insurers still require a referral for payment.
- –Hospital outpatient therapy departments attach facility fees to the evaluation that private clinics do not.
Questions to Ask Before Booking
- 1.Do I need a physician referral for my insurance to pay, even though my state allows direct access?
- 2.What does the evaluation cost, and will treatment on the same day be billed on top?
- 3.Does the evaluation count against my plan's annual visit limit?
- 4.After evaluating me, how many visits and units per visit do you anticipate?
- 5.Is your clinic hospital-owned, and is there a facility fee on this evaluation?
Other featured procedures in Alaska
PT Evaluation (Low Complexity) in other states
PT Evaluation (Low Complexity) in Alaska: questions
Alaska is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 97161 is $126.43 in an office and $126.43 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Alaska uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $25 for the office physician line or $25 for the hospital physician line in Alaska. Medigap may cover that 20%. This is not the hospital facility fee.
No. $126.43 is the Medicare physician allowed amount for CPT 97161. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Alaska ranks #51 of 51 states on this physician line (29% above the national office rate of $97.86).