Average Medicaid Physical Therapy Payments in O Fallon, IL: $52.22
Avg. Paid
$52.22
Range
$7.93 – $102.40
Total Claims
16,738
Providers
6
Typical Payment Range
Typical Medicaid Physical Therapy payments fall between $19.59 and $59.02 per claim (median: $32.75). The top 10% of payments exceed $86.40.
Based on per-provider averages across all Medicaid claims in this category.
Physical therapy helps restore movement and function when someone is affected by injury, illness, or disability. Includes exercises, manual therapy, and modalities.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Physical Therapy in O Fallon, IL
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
St Elizabeths Hospital Of The Hospital Sisters Of The Third Order
1 Saint Elizabeth Blvd |
$102.40 | 6,197 | 1,760 |
|
Ofallon Ccsd 90
707 N Smiley St |
$14.15 | 5,327 | 1,846 |
|
St Elizabeths Hospital Of The Hospital Sisters Of The Third Order
1 Saint Elizabeth Blvd |
$34.40 | 3,528 | 544 |
|
Shiloh Village School District 85
125 Diamond Ct |
$9.73 | 935 | 314 |
|
Stacy Elizabeth Bragg
634 N Main St |
$46.00 | 729 | 160 |
|
Maria Louise Cunningham
916 Talon Dr |
$7.93 | 22 | 12 |
What to Expect: Physical Therapy
Physical therapy sessions typically last 30-60 minutes. Your first visit includes an evaluation where the therapist assesses your condition and creates a treatment plan. Sessions may include stretching, strengthening exercises, manual therapy, ultrasound, electrical stimulation, or heat/ice therapy. Most treatment plans involve 2-3 sessions per week for several weeks.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 97110 | Therapeutic exercises | $36.58 | 135,669,845 | 56,453 |
| 97530 | Therapeutic activities | $49.28 | 126,200,638 | 53,019 |
| 97140 | Manual therapy techniques | $19.55 | 45,357,985 | 26,587 |
| 97112 | Neuromuscular reeducation | $24.45 | 37,646,570 | 25,985 |
| 97535 | Self-care training | $72.94 | 21,914,840 | 7,790 |
| 97150 | Group therapeutic procedure | $58.98 | 10,916,093 | 6,468 |
| 97116 | Gait training therapy | $19.91 | 6,172,658 | 3,724 |
| 97161 | PT eval low complexity | $54.82 | 4,464,808 | 8,341 |
| 97162 | PT eval moderate complexity | $53.65 | 3,173,942 | 6,316 |
| 97124 | Therapeutic massage | $51.08 | 3,114,141 | 1,206 |
| 97113 | Aquatic therapy | $62.25 | 1,126,860 | 1,234 |
| 97165 | OT eval low complexity | $55.88 | 940,983 | 2,183 |
| 97164 | PT re-evaluation | $38.89 | 790,759 | 2,769 |
| 97163 | PT eval high complexity | $54.70 | 754,018 | 1,953 |
| 97166 | OT eval moderate complexity | $65.44 | 617,431 | 1,845 |
| 97167 | OT eval high complexity | $71.77 | 327,373 | 822 |
| 97168 | OT re-evaluation | $64.00 | 279,352 | 1,132 |
| 97542 | Wheelchair training | $30.27 | 252,292 | 394 |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Physical Therapy cost in O Fallon, IL?
Based on public Medicaid payment data, the average Medicaid reimbursement for Physical Therapy in O Fallon, IL is $52.22 per claim, based on 16,738 claims from 6 providers. Typical payments fall between $19.59 and $59.02. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Physical Therapy in O Fallon, IL?
There are 6 Medicaid providers offering Physical Therapy related services in O Fallon, IL according to public payment data.
What is the price range for Physical Therapy in O Fallon, IL?
Medicaid reimbursement for Physical Therapy in O Fallon, IL ranges from $7.93 to $102.40 per claim, with an average of $52.22. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Physical Therapy in Other Cities
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Avg $36.50
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New York, NY
Avg $39.29
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Phoenix, AZ
Avg $44.43
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Louisville, KY
Avg $91.42
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Miami, FL
Avg $41.78
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Bronx, NY
Avg $33.00
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Indianapolis, IN
Avg $33.23
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Las Vegas, NV
Avg $41.92
2,229,957 claims · 556 providers
Other Procedures in O Fallon, IL
Office Visit
Avg $32.51
144,742 claims
Emergency Room Visit
Avg $80.52
109,477 claims
Eye Exam
Avg $30.64
43,999 claims
Speech Therapy
Avg $16.96
40,952 claims
EKG / ECG (Electrocardiogram)
Avg $10.31
34,153 claims
Blood Work & Lab Tests
Avg $7.91
28,655 claims
Dental Cleaning & Exam
Avg $52.49
13,618 claims
Ambulance Transport
Avg $195.13
10,353 claims