PT Evaluation (Moderate Complexity) Cost in District of Columbia
Pt eval mod complex 30 min
District of Columbia Average Cost (2026)
+11.3% vs national avgAverage across 1 Medicare locality in District of Columbia
National Average
State Ranking
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About PT Evaluation (Moderate Complexity) Costs in District of Columbia
The average Medicare reimbursement for pt evaluation (moderate complexity) in District of Columbia is $108.88 for an office setting and $108.88 in a hospital. This is about 11% higher than the national average of $97.86.
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. For this procedure in District of Columbia, that would be roughly $22 for an office visit or $22 in a hospital setting.
Private insurance plans in District of Columbia typically pay between 130% and 200% of Medicare rates for this procedure, putting the total somewhere between $142 and $218.
Without insurance, you may be able to negotiate a cash discount. Many providers in District of Columbia will reduce their fees by 20% to 40% for self-pay patients. Always ask about cash pricing before scheduling your procedure.
Ways to Save on PT Evaluation (Moderate Complexity)
Compare Insurance Plans
Uninsured? Comparing marketplace plans in District of Columbia could save you thousands on procedures like this.
Compare plans on eHealth →Try Telehealth First
Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.
Book on Sesame Care →Save on Prescriptions
If this procedure leads to a prescription, check discount cards for up to 80% savings.
Check prices on GoodRx →Some links are affiliate links. We may earn a commission at no extra cost to you.
More ways to save →Other Procedures in District of Columbia
PT Evaluation (Moderate Complexity) Cost by State
PT Evaluation (Moderate Complexity) in District of Columbia: Frequently Asked Questions
How much does pt evaluation (moderate complexity) cost in District of Columbia?
The average 2026 Medicare rate for pt evaluation (moderate complexity) (CPT 97162) in District of Columbia is $108.88 in an office setting and $108.88 in a hospital. Private insurance typically pays $142 to $218, and self-pay cash prices often run $87 to $163.
Is pt evaluation (moderate complexity) cheaper in District of Columbia than the national average?
District of Columbia is about 11% higher than the national average of $97.86. Across all states, District of Columbia ranks #48 of 49 for this procedure. The cheapest state is Arkansas ($91.20) and the most expensive is Alaska ($126.43).
What will I pay out of pocket for pt evaluation (moderate complexity) in District of Columbia with Medicare?
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. In District of Columbia that is roughly $22 for an office visit or $22 in a hospital setting.
How can I save on pt evaluation (moderate complexity) in District of Columbia?
Ask providers for a cash or self-pay price before scheduling; many in District of Columbia reduce fees 20% to 40% for self-pay patients. If you are uninsured, comparing marketplace plans, using telehealth for consultations, and checking prescription discount cards can cut costs further.