CPT97161

How Much Does a PT Evaluation (Low Complexity) Cost in Kansas?

Pt eval low complex 20 min

$93.27Kansas physician fee2026 Medicare office rate

Under 2026 Medicare rates, a PT evaluation (low complexity) costs about $93 in Kansas.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Kansas Medicare physician rate (2026)

-4.7% vs national

Single statewide locality.

Kansas (Hospital)
$93.27
Facility physician fee
Private plan est.
$121–$187
~130–200% of Medicare
Cash / self-pay est.
$75–$140
~80–150% of Medicare

Your ZIP in Kansas

Enter a ZIP code for your part of Kansas, from Overland Park and the Kansas City suburbs to Wichita, Topeka, Lawrence, Salina, and the western High Plains.

What PT evaluation (low complexity) costs at hospitals near you

Everything above is a national average. The hospital you pick in Kansas moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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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 center 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 Kansas

National office$97.86
National hospital (physician)$97.86
Kansas vs national5% below the national office rate of $97.86

Where Kansas ranks for this CPT

Rank (lowest physician fee first)#7 of 51
Lowest stateArkansas ($91.20)
Highest stateAlaska ($126.43)

PT Evaluation (Low Complexity) and how Kansas is priced

A single locality covers all of Kansas, with geographic indices in the lower national tier, so the published Medicare rates apply evenly from the Kansas City suburbs to the far western High Plains. Notably, the Kansas side of the Kansas City metro prices under the statewide Kansas locality while the Missouri side has its own metro locality, meaning the two halves of one city carry different approved amounts. Beyond that quirk, Kansas pricing is straightforwardly uniform. Wichita, Topeka, and rural Kansas all share the same adjustments.

The Kansas City metro and Wichita hold most of the state's specialists, with the academic medical center on the Kansas side of the metro serving as the top referral point. Western Kansas is genuinely frontier in places, with long distances to any hospital that performs advanced procedures, and some High Plains residents cross into Colorado or Nebraska for care. Critical access hospitals carry much of the rural load.

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?

PT Evaluation (Low Complexity) in Kansas: questions

Under 2026 Medicare rates, a PT evaluation (low complexity) costs about $93 in Kansas. Kansas is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. Kansas 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 $19 for the office physician line or $19 for the hospital physician line in Kansas. Medigap may cover that 20%. This is not the hospital facility fee.

No. $93.27 is the Medicare physician allowed amount for CPT 97161. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Kansas ranks #7 of 51 states on this physician line (5% below the national office rate of $97.86).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.