Physical therapy (therapeutic exercise)

For the CPT code 97110, representing physical therapy (therapeutic exercise), the facility's cash median rate is $50.00, while the median negotiated rate across 38 payers is $40.00. This indicates that for patients with high-deductible plans, paying cash directly might be more cost-effective than using insurance, as the negotiated rates often exceed the cash price due to administrative overhead and contract structures. While the facility is a Critical Access Hospital in Satanta, KS, the data provided does not include specific state or county average benchmarks for comparison, so patients should focus on verifying their specific plan's negotiated amount before scheduling to ensure they are not paying above the allowed rate.

It is important to note that Medicare sets a benchmark of $29.06 for this service, which serves as a scientifically validated baseline for cost. Commercial negotiated rates can vary significantly, with the lowest allowed amount found at Direct Benefit-All Plans at $12 and the highest at Medicaid/KanCare at $70. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. To minimize costs, patients are encouraged to request a prompt-pay discount or self-pay rate before check-in, as paying in full upfront can bypass the administrative fees associated with insurance claims processing.