CMS Price Transparency Data

Physical therapy (gait training)

Facility: PAM Rehabilitation Hospital of Beaumont

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $67
Cash Discount Price: $90
vs. Medicare Baseline: 2.31x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at PAM Rehabilitation Hospital of Beaumont is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.31x the Medicare baseline. Located in 3340 Plaza 10 Drive, Beaumont, TX.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)

Cash / Self-Pay: $90 (310%)

Insurance Median: $67 (231%)

Cash: $90 (310% of Medicare)

Ins. Median: $67 (231% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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 231% of the Medicare baseline (a markup of 131%). 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
Aetna	$9 - $19	31%
Curative	$21	72%
Caresource	$29	100%
Blue Cross Blue Shield	$34	117%
Christus Health Plan	$36	124%
Imperial Insurance Of Texas	$36	124%
Ninety Degree Benefits	$45	155%
Healthcare Highways	$49	169%
Ilumed Aco Reach	$58	200%
America'S Choice Provider Network	$63	217%
Provider Network Of America	$67	231%
Quik Trip	$67	231%
Usa Managed Care Organization	$67	231%
Velocity Provider Ppo Network	$67	231%
Cigna	$70 - $115	241%
Memorial Hermann Health Plan	$70	241%
Multiplan/Phcs	$72	248%
Prime Health Services	$76	262%
Select Care	$90	310%
Today'S Option	$90	310%

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 $90.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm PAM Rehabilitation Hospital of Beaumont is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97116.
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.