Average Medicaid Physical Therapy Payments
Typical Medicaid Physical Therapy reimbursement across 9,125 cities
Avg. Medicaid Paid
$40.38
Price Range
$0.00 – $1,762
Total Claims
358.1M
Cities
9125
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.
About This Procedure
Physical therapy helps restore movement and function when someone is affected by injury, illness, or disability. Includes exercises, manual therapy, and modalities.
Why do these costs look low?
These figures represent Medicaid reimbursement rates — the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.
Costs by City
| City | Avg. Paid | Min / Max | Claims | Providers |
|---|---|---|---|---|
| Dunkirk, NY | $74.68 | $51.31 – $83.23 | 18,387 | 6 |
| Mount Vernon, IL | $61.70 | $8.26 – $233.14 | 18,401 | 11 |
| Edwardsville, IL | $51.11 | $8.96 – $72.98 | 18,408 | 9 |
| Lake City, FL | $15.87 | $10.26 – $72.14 | 18,411 | 7 |
| Duarte, CA | $27.43 | $6.51 – $52.06 | 18,455 | 3 |
| Tucumcari, NM | $49.20 | $49.20 – $49.20 | 18,459 | 1 |
| Hempstead, NY | $34.49 | $9.77 – $66.84 | 18,466 | 8 |
| Indian Trail, NC | $34.72 | $4.95 – $91.68 | 18,467 | 13 |
| Odessa, DE | $24.33 | $24.31 – $25.49 | 18,471 | 2 |
| Glen Mills, PA | $35.40 | $0.16 – $307.56 | 18,482 | 14 |
| Tonasket, WA | $113.05 | $20.43 – $114.97 | 18,486 | 2 |
| Rockledge, PA | $19.81 | $2.73 – $29.66 | 18,490 | 5 |
| Mason City, IA | $31.97 | $5.66 – $47.64 | 18,500 | 11 |
| Kemp, TX | $63.86 | $0.06 – $87.24 | 18,512 | 2 |
| Colchester, VT | $79.19 | $12.69 – $102.86 | 18,523 | 9 |
| Mamaroneck, NY | $39.68 | $24.33 – $58.17 | 18,545 | 6 |
| Oxford, AL | $29.19 | $5.24 – $54.20 | 18,554 | 8 |
| Pinecrest, FL | $57.19 | $55.91 – $68.53 | 18,560 | 2 |
| Hawesville, KY | $23.67 | $0.00 – $24.90 | 18,561 | 4 |
| Cidra, PR | $21.90 | $18.98 – $91.18 | 18,563 | 4 |
| Milford, OH | $21.13 | $15.35 – $31.19 | 18,570 | 6 |
| Oakdale, LA | $31.95 | $11.25 – $46.93 | 18,594 | 2 |
| Bowie, MD | $40.09 | $8.49 – $94.45 | 18,601 | 23 |
| Lower Burrell, PA | $17.47 | $13.05 – $127.04 | 18,602 | 15 |
| Saranac Lake, NY | $74.81 | $74.81 – $74.81 | 18,626 | 1 |
| Petersburg, IN | $12.60 | $11.73 – $13.91 | 18,627 | 3 |
| Ocean City, MD | $34.91 | $28.06 – $38.57 | 18,635 | 3 |
| Gorham, ME | $18.64 | $9.61 – $63.78 | 18,641 | 13 |
| Sunland, CA | $34.00 | $26.78 – $35.38 | 18,651 | 3 |
| Hertford, NC | $90.45 | $50.93 – $93.92 | 18,662 | 3 |
| Castro Valley, CA | $19.87 | $13.91 – $42.59 | 18,675 | 4 |
| Batesville, IN | $31.62 | $20.11 – $73.87 | 18,682 | 7 |
| Weatherford, TX | $17.42 | $0.00 – $143.98 | 18,684 | 10 |
| Baldwin Park, CA | $16.60 | $0.00 – $81.38 | 18,703 | 26 |
| Herkimer, NY | $50.42 | $29.48 – $122.22 | 18,709 | 12 |
| Makawao, HI | $31.63 | $10.44 – $68.82 | 18,729 | 8 |
| Hummelstown, PA | $43.89 | $6.32 – $129.21 | 18,739 | 10 |
| Oswego, IL | $11.81 | $7.90 – $129.67 | 18,743 | 4 |
| Portland, TN | $19.33 | $13.71 – $30.30 | 18,766 | 8 |
| Mexico, NY | $61.44 | $18.35 – $74.56 | 18,772 | 11 |
| Parkin, AR | $37.71 | $24.36 – $74.07 | 18,795 | 2 |
| Nashville, NC | $41.11 | $0.00 – $74.11 | 18,803 | 9 |
| Fleetwood, PA | $18.59 | $14.03 – $40.80 | 18,809 | 3 |
| Hornell, NY | $52.62 | $34.97 – $257.22 | 18,819 | 16 |
| Pleasantville, NJ | $0.62 | $0.62 – $0.62 | 18,832 | 1 |
| Wylie, TX | $12.51 | $0.10 – $326.04 | 18,837 | 6 |
| Hancock, MI | $29.32 | $29.32 – $29.32 | 18,846 | 1 |
| Plains, MT | $9.56 | $1.23 – $37.22 | 18,912 | 4 |
| Calais, ME | $6.93 | $4.32 – $6.93 | 18,915 | 2 |
| Guntersville, AL | $22.66 | $0.45 – $76.49 | 18,923 | 9 |
Cost Components
National averages for each billing code in this procedure category. Sorted by claim volume.
| 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 averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.