CPT 97168 Physical Therapy/Rehab
Ot re-eval est plan care Cost
Body System: Musculoskeletal
Medicare Facility Rate
$68
CMS PFS CY2026
Medicare Non-Facility Rate
$68
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.96
Work RVU
1.08
Facility PE RVU
0.01
Malpractice RVU
2.05
Total RVU
Frequently Asked Questions
How much does Ot re-eval est plan care cost?
The Medicare facility rate is $68. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Ot re-eval est plan care cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $68.