Physical Therapy and Chiropractic Insurance Rates

What commercial insurers pay physical therapists and chiropractors for the codes they bill most, from the payers' own published in-network rate files.

First data arrives with our next monthly refresh. We have started reading physical therapy and chiropractic rates from the payer files. This page will show medians by state, payer and code once that run finishes. Until then, the sections below explain the codes and what drives the rates, without estimates.

The Codes

Physical Therapists

97161 (PT evaluation, low complexity). Evaluation, low complexity. Billed once per episode, not in time units.
97162 (PT evaluation, moderate complexity). Evaluation, moderate complexity. Billed once per episode.
97163 (PT evaluation, high complexity). Evaluation, high complexity. Billed once per episode.
97110 (Therapeutic exercise, 15 min). Therapeutic exercise for strength, endurance, range of motion and flexibility. Timed code, per 15 minutes.
97112 (Neuromuscular re-education, 15 min). Neuromuscular re-education for balance, coordination and proprioception. Timed code, per 15 minutes.
97140 (Manual therapy, 15 min). Manual therapy such as mobilization, manipulation and soft tissue techniques. Timed code, per 15 minutes. Billed by both physical therapists and chiropractors.
97530 (Therapeutic activities, 15 min). Therapeutic activities using dynamic, functional movement. Timed code, per 15 minutes.

Chiropractors

98940 (Spinal manipulation, 1-2 regions). Chiropractic manipulative treatment, one to two spinal regions. Billed per visit.
98941 (Spinal manipulation, 3-4 regions). Chiropractic manipulative treatment, three to four spinal regions. Billed per visit.
97140 (Manual therapy, 15 min). Manual therapy such as mobilization, manipulation and soft tissue techniques. Timed code, per 15 minutes. Billed by both physical therapists and chiropractors.

How Physical Therapy Rates Vary

Per unit, not per visit. Most treatment codes are paid per 15 minute unit. Two visits with the same total time can pay differently depending on how the minutes are split across codes.
Evaluation complexity. The three evaluation codes are paid at different levels, and the documented complexity has to support the level billed.
Multiple unit reductions. Medicare reduces payment for the practice expense part of the second and later therapy units on the same day, and many commercial contracts follow a similar rule.
Separate networks. Some plans manage physical therapy and chiropractic care through a contracted specialty network, so the rate comes from that network's fee schedule rather than the plan's main one. See how specialty networks like ASH work.
Modifiers. Therapy claims usually carry a discipline modifier such as GP. Our figures use the base rate for each code without a modifier, so a contract that pays differently with a modifier can differ from the numbers shown.

Method

Rates come from each payer's Transparency in Coverage in-network files. Clinicians are individual NPIs in the CMS NPPES registry with a physical therapist or chiropractor taxonomy and a practice location in the state. Each clinician counts once per code and network. Where a payer publishes several networks, the one covering the most clinicians for that state, provider type and code is shown. The median is the middle negotiated rate across those clinicians, not what any one provider is paid. More on the method.

Frequently Asked Questions

How are physical therapy codes paid?

Evaluations (97161 to 97163) are paid once per episode at a level set by complexity. Treatment codes such as 97110, 97112, 97140 and 97530 are timed and paid per 15 minute unit, so a visit is paid as the sum of its units. Many payers also cap units per visit or reduce the rate for the second and later units.

Why do physical therapy rates differ so much between payers?

Payers set fee schedules by network and contract, and many route physical therapy and chiropractic care through a separate managed network or benefit manager with its own rates. Rates also differ by state, by whether the practice contracts as an individual or a group, and by when the contract was signed.

Where will this data come from?

From each payer's Transparency in Coverage in-network rate files, the same source as our therapist and psychologist reports. PECS matches each negotiated rate to the clinician's NPI and keeps individual physical therapists and chiropractors with a practice location in the state.

Can a physical therapist or chiropractor negotiate rates?

Often, yes, when you can show the payer that your rates sit below what it pays comparable providers in your state, or that you fill an access gap. A written, code-specific request is the usual starting point.

Think a payer is underpaying you? Check your rates for free, or start with PECS for credentialing with the plans you are missing. Credentialing for therapists is covered in our PT, OT and speech guide.

By the PECS credentialing team. Updated October 2026.