PT Evaluation (Moderate Complexity) Cost in Pennsylvania
Pt eval mod complex 30 min
Pennsylvania Average Cost (2026)
-0.5% vs national avgAverage across 2 Medicare localities in Pennsylvania
National Average
State Ranking
Cost by Region in Pennsylvania
| Region | Office Rate |
|---|---|
| metropolitan philadelphia | $100.74 |
| rest of pennsylvania | $94.07 |
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Enter your ZIP code to see costs adjusted for your specific locality within Pennsylvania
About PT Evaluation (Moderate Complexity) Costs in Pennsylvania
The average Medicare reimbursement for pt evaluation (moderate complexity) in Pennsylvania is $97.41 for an office setting and $97.41 in a hospital. This is close to the national average of $97.86.
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. For this procedure in Pennsylvania, that would be roughly $19 for an office visit or $19 in a hospital setting.
Private insurance plans in Pennsylvania typically pay between 130% and 200% of Medicare rates for this procedure, putting the total somewhere between $127 and $195.
Without insurance, you may be able to negotiate a cash discount. Many providers in Pennsylvania 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 Pennsylvania 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 Pennsylvania
PT Evaluation (Moderate Complexity) Cost by State
PT Evaluation (Moderate Complexity) in Pennsylvania: Frequently Asked Questions
How much does pt evaluation (moderate complexity) cost in Pennsylvania?
The average 2026 Medicare rate for pt evaluation (moderate complexity) (CPT 97162) in Pennsylvania is $97.41 in an office setting and $97.41 in a hospital. Private insurance typically pays $127 to $195, and self-pay cash prices often run $78 to $146.
Is pt evaluation (moderate complexity) cheaper in Pennsylvania than the national average?
Pennsylvania is close to the national average of $97.86. Across all states, Pennsylvania ranks #26 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 Pennsylvania with Medicare?
Medicare patients typically pay 20% of the Medicare rate after meeting their deductible. In Pennsylvania that is roughly $19 for an office visit or $19 in a hospital setting.
How can I save on pt evaluation (moderate complexity) in Pennsylvania?
Ask providers for a cash or self-pay price before scheduling; many in Pennsylvania 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.