Physical Therapy Evaluation: what it covers and what it costs
What does a Physical Therapy Evaluation cost? Across 36 major U.S. metros, the typical insurer-negotiated price for a PT Evaluation (CPT 97161 / 97162 / 97163) runs from about $59 in Indianapolis, IN to $824 in Baltimore, MD, read from hospitals' own price-transparency files. 20 of those metros have at least one hospital publishing a self-pay cash price. This page explains what the billing code covers, what the quoted price does and does not include, and what actually drives the spread between hospitals. These are price references from public data — not a quote, a bill, or medical or financial advice.
These figures are aggregated from hospitals' public price-transparency files — not a quote, a bill, an insurance benefit determination, or medical advice. Your actual out-of-pocket cost depends on your insurance plan (deductible, copay, coinsurance, network), the exact service and any complications, and which hospital you use. Always confirm price and coverage with the hospital and your insurer before care.
What a PT Evaluation price actually covers
A physical therapy evaluation is the initial assessment that establishes a plan of care. It is coded at one of three complexity levels — low, moderate or high — based on the assessment's clinical complexity, not its length.
Code scope. Tiered by complexity: 97161 (low), 97162 (moderate), 97163 (high) - all three included since they are the same eval service priced similarly (CMS reimburses the tiers equally). Re-evaluation is 97164. These replaced the old 97001.
What is — and isn't — in the price
The published price covers the evaluation visit itself. Treatment delivered in the same session is billed under separate procedure codes, most of them in fifteen-minute units, so a first appointment routinely produces more than one charge.
Why PT Evaluation prices differ so much between hospitals
Hospital outpatient therapy departments frequently carry a facility fee that private practices do not, which is the main source of spread. The evaluation's complexity level moves the price modestly; the number of treatment units billed alongside it usually moves the total more.
What else usually lands on the bill
Treatment codes billed in fifteen-minute units accompany the evaluation and continue at every subsequent visit. Re-evaluation is its own code, and any bracing or supportive equipment is supplied and billed separately.
What to ask before you book
Ask what a typical first visit bills in total, not just the evaluation code, and whether the site charges a facility fee. Then ask the expected number of visits — the course of care, not the visit, is the real cost.
Where the money actually moves
Private practice clinics typically avoid the facility fee hospital outpatient departments add. Ask what a full course of care is expected to cost rather than the first visit alone, and whether a home programme can reduce the number of visits.
What the PT Evaluation numbers show nationally
A PT Evaluation costs 14.0× as much in Baltimore as in Indianapolis
Across the 36 metros priced here, the typical negotiated rate runs from $59 in Indianapolis, IN to $824 in Baltimore, MD — the same billing codes, the same procedure, 1304% apart.
The individual hospitals reporting the lowest and highest PT Evaluation prices
Lowest: ALLIANCE HEALTHCARE SYSTEM (Memphis, TN) at $1; JEFFERSON STRATFORD HOSPITAL (Philadelphia, PA) at $14; FRANCISCAN HEALTH MOORESVILLE (Indianapolis, IN) at $50. Highest: MEDSTAR HARBOR HOSPITAL (Baltimore, MD) at $1,083; MEDSTAR SOUTHERN MARYLAND HOSPITAL CENTER (Washington, DC) at $923; MEDSTAR GOOD SAMARITAN HOSPITAL (Baltimore, MD) at $841. These are the figures each hospital published in its own file, not an assessment of the care.
20 of 36 metros have a hospital publishing a self-pay PT Evaluation price
Cheapest published cash price: $81 (Phoenix). A cash price is what the hospital will accept from someone paying directly; it is not required and many never publish one.
Insurers pay about 62% below the list price for a PT Evaluation
Across the 30 metros publishing both, the chargemaster list price is typically 62% above what insurers negotiate. The widest gap is in Miami: $1,330 list against $105 negotiated.
How many hospitals actually publish a PT Evaluation price
238 hospital price-file entries across 36 metros feed this page. A hospital appears only where its own file lists a rate for CPT 97161 / 97162 / 97163 — where it does not, it is absent from the table rather than filled in with a guess.
PT Evaluation price by metro
The typical insurer-negotiated price for a PT Evaluation, by metro — lowest first. 20 of these 36 metros have at least one hospital publishing a self-pay cash price; 31 publish a chargemaster list price. Open a metro for its full hospital-by-hospital breakdown and who those hospitals are.
| Metro | Typical negotiated | Range | Cash | Hospitals |
|---|---|---|---|---|
| Indianapolis, IN | $59 | $50–$104 | $135 | 4 |
| Virginia Beach, VA | $104 | $104 | — | 6 |
| Orlando, FL | $105 | $104–$248 | — | 3 |
| Tampa, FL | $105 | $104–$154 | — | 6 |
| Miami, FL | $105 | $99–$155 | — | 4 |
| Dallas, TX | $105 | $100–$336 | $264 | 10 |
| Buffalo, NY | $106 | $95–$129 | — | 3 |
| Portland, OR | $109 | $104–$537 | — | 8 |
| Detroit, MI | $126 | $66–$200 | $173 | 6 |
| Hartford, CT | $132 | $104–$292 | — | 4 |
| Houston, TX | $133 | $101–$420 | — | 6 |
| Los Angeles, CA | $139 | $107–$205 | — | 3 |
| Oklahoma City, OK | $144 | $124–$277 | — | 3 |
| Raleigh, NC | $147 | $96–$147 | $214 | 3 |
| Atlanta, GA | $148 | $93–$429 | $177 | 9 |
| St. Louis, MO | $153 | $128–$169 | $257 | 7 |
| Kansas City, MO | $154 | $93–$415 | — | 7 |
| Riverside, CA | $156 | $103–$269 | $316 | 4 |
| Seattle, WA | $158 | $113–$531 | $147 | 7 |
| Nashville, TN | $162 | $97–$202 | — | 9 |
| Birmingham, AL | $193 | $92–$220 | — | 9 |
| Memphis, TN | $194 | $1–$199 | — | 5 |
| Cleveland, OH | $215 | $119–$254 | $393 | 8 |
| Phoenix, AZ | $220 | $83–$434 | $81 | 10 |
| Philadelphia, PA | $227 | $14–$657 | $243 | 15 |
| Austin, TX | $230 | $105–$589 | $119 | 9 |
| New York, NY | $231 | $112–$321 | $367 | 7 |
| Chicago, IL | $236 | $230–$260 | $160 | 3 |
| Jacksonville, FL | $240 | $240 | $101 | 3 |
| San Antonio, TX | $253 | $83–$361 | — | 5 |
| Pittsburgh, PA | $255 | $202–$289 | $382 | 5 |
| Milwaukee, WI | $259 | $181–$378 | $240 | 9 |
| San Diego, CA | $267 | $55–$324 | $360 | 6 |
| Washington, DC | $267 | $202–$923 | $213 | 8 |
| Denver, CO | $316 | $101–$381 | $307 | 10 |
| Baltimore, MD | $824 | $702–$1,083 | — | 4 |
Source: hospitals' own machine-readable Standard Charges files, published under the U.S. Hospital Price Transparency rule (45 CFR §180.50). Most recent hospital file in this dataset: July 2026. Prices are references, not quotes or bills, and never medical or financial advice — where a hospital reports no price, nothing is shown rather than a guess.
Frequently asked questions
- How much does a PT Evaluation cost?
- Across 36 U.S. metros the typical insurer-negotiated price is about $158, ranging from $59 in Indianapolis to $824 in Baltimore. Every figure is read from a named hospital's own price-transparency file for CPT 97161 / 97162 / 97163.
- Does the price include the doctor's fee?
- The published price covers the evaluation visit itself. Treatment delivered in the same session is billed under separate procedure codes, most of them in fifteen-minute units, so a first appointment routinely produces more than one charge.
- Why do PT Evaluation prices differ so much between hospitals?
- Hospital outpatient therapy departments frequently carry a facility fee that private practices do not, which is the main source of spread. The evaluation's complexity level moves the price modestly; the number of treatment units billed alongside it usually moves the total more.