Health Care Fee Schedule for Integrative Physical Therapy and Spine Treatment Center, Inc | 2021

This notice is being posted in accordance with AS 18.23.400. Disclosure and reporting of health care services, prices and fee information. Effective January 1, 2021 and until further notice, Integrative Physical Therapy charges for following undiscounted fees for the listed health care services. You will be provided an estimate of the anticipated charges for your nonemergency care upon request. Please do not hesitate to ask for information. The undiscounted prices listed may be higher or lower than the amount an individual actually pays for the health care services described. Integrative Physical Therapy is contracted to provide health care services as an in-network preferred provider with Premera Blue Cross Blue Shield of Alaska, Aetna, Cigna, Multiplan, Tricare, Workmans compensation, Medicaid, and Medicare will accept patient with auto accidents who have a case number. Please note some insurances have different coverage and/or co-pays depending on the specific plan you are enrolled in.

Alaska's department of Health and Social Services website can be found here: http://dhss.alaska.gov/

CPT code / Procedure
Description
Price
97110 Therapeutic exercise
A therapeutic procedure, to develop strength and endurance, range of motion and flexibility.
$103
per unit
97012 Mechanical Traction
Application of a modality to 1 or more areas; traction, mechanical - stretching of the neck or back with a machine
$60
97161 Initial Evaluation
Physical therapy evaluation: An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions.
$206
970101 Heat or Ice
The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.
$53.
97112 Neuro-muscular re-education
Therapeutic procedure, 1 or more areas; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities.
$101
per unit
97140 Manual Therapy
Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions. Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy helps in improving joint mobility, alignment, tissue repair, lymphatic drainage, and traction.
$79
Per unit
97014 Electrical stimulation
The provider, who is typically a physical therapist, applies an electrical current to nerves or to a muscle or group of muscles, causing them to contract. It is used to restore function to a body part that is affected by disease or trauma, such as a head or spinal cord injury. Also can be used for pain reduction and muscle relaxation without a contraction ellicited.
$59
97035 Ultrasound
Physical therapists use a sound head and mechanical energy that can help relax and heal muscles from their strained conditions. Application of a modality to 1 or more areas; ultrasound.
$64
per unit
97116 Gait training
The provider instructs the patient in the proper ways of mobility, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without strain with or without an assistive device.
$91
Per unit
97164 Re-evaluation
Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family
$103

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