CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: PAM Health Specialty Hospital of Reno

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $240
Cash Discount Price: $313
vs. Medicare Baseline: 7.33x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at PAM Health Specialty Hospital of Reno is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $313. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 7.33x the Medicare baseline. Located in 235 W 6Th St, Reno, NV.

Cash / Self-Pay

$313

Average discount available for prompt cash payment at this facility.

Insurance Median

$240

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)

Cash / Self-Pay: $313 (956%)

Insurance Median: $240 (733%)

Cash: $313 (956% of Medicare)

Ins. Median: $240 (733% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 733% of the Medicare baseline (a markup of 633%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
America'S Choice	$197 - $240	602%
Provider Network Of Amercia	$211 - $258	645%
Quik Trip	$211 - $258	645%
Usa Managed Care Organization	$211 - $258	645%
Velocity Provider Ppo Network	$211 - $258	645%
Healthsmart	$220 - $268	672%
Evolutions Healthcare System	$226 - $275	690%
Multiplan	$226 - $275	690%
Beech Street	$240 - $292	733%
Galaxy Health Network	$240 - $292	733%
Prime Health Services	$240 - $292	733%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $313.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

Insurance In-Network Protection Plan

Contact your insurance company to confirm PAM Health Specialty Hospital of Reno is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97112.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.