Doctor visits and therapy CPT 97162 Outpatient

PT evaluation, mod. complexity cost in Worcester, MA

In Worcester, MA, 4 hospitals list a cash price for physical therapy evaluation, moderate complexity (typically about 30 minutes): from $329.00 to $700.00, with a median of $496.00. The lowest listed price is at Milford Regional Medical Center — $167.00 less than the median here. Across Massachusetts, the median is $355.43 at 16 hospitals.

Cash prices at 4 facilities across 4 cities for code 97162, as an outpatient — the setting a self-pay patient normally buys. Collected Sep 23, 2026; the hospital files themselves were last updated between Mar 26, 2026 and Apr 3, 2026.

Lowest$329.00Milford Regional Medical Center
Median$496.00half pay less
Highest$700.00in this market
Difference2.1×highest vs lowest

Where each hospital's price falls

Each dot is one hospital's cash price on a scale from the lowest to the highest in Worcester, MA.

median
Lowest $329.00Highest $700.00

Hospitals, cheapest first

HospitalCash price List priceInsurers payOff listFile date
Milford Regional Medical Center lowest Milford, MA · (508) 473-1190 Moderate Comp Eval 15 Minutes $329.00 $329.00 $329.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 15 Minutes $346.00 $346.00 $346.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 30 Minutes $346.00 $346.00 $346.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Comp Eval 60 Minutes $362.00 $362.00 $362.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 45 Minutes $362.00 $362.00 $362.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 75 Minutes $378.00 $378.00 $378.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 60 Minutes $378.00 $378.00 $378.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Comp Eval 75 Minutes $394.00 $394.00 $394.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 90 Minutes $394.00 $394.00 $394.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 105 Minute $410.00 $410.00 $410.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Comp Eval 90 Minutes $410.00 $410.00 $410.00 — —
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UMass Memorial Health - Harrington Hospital Southbridge, MA · (508) 765-9771 HC Pt Evaluation Moderate Complexity $426.00 $426.00 — — Apr 3, 2026
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Comp Eval 105 Minutes $427.00 $427.00 $427.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 120 Minute $427.00 $427.00 $427.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Comp Eval 120 Minutes $443.00 $443.00 $443.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 150 Minute $459.00 $459.00 $459.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Moderate Compl Eval 180 Minute $475.00 $475.00 $475.00 — —
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Milford Regional Medical Center Milford, MA · (508) 473-1190 Pt eval mod complex 30 min $475.00 $475.00 $76.57–$305.66 — —
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UMass Memorial Medical Center Worcester, MA · (508) 334-1000 HC Pt Evaluation Moderate Complexity $566.00 $566.00 — — Mar 26, 2026
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HealthAlliance - Clinton Hospital Leominster, MA · (978) 466-2000 HC Pt Evaluation Moderate Complexity $700.00 $700.00 — — Mar 26, 2026
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Outpatient: lowest $329.00, median $496.00, highest $700.00 — a 2.1× difference within the same market.

As an inpatient, the same code is billed by 4 facilities here, median $496.00. Inpatient and outpatient prices are not comparable and are kept on separate pages: the inpatient charge covers admission, not the same purchase.

Cash or insurance?

At the one hospital here that publishes insurer rates for this code, the cash price is not below the highest rate a health plan has negotiated. If you have insurance but have not met your deductible, you usually pay your plan's negotiated rate, which falls somewhere in the "Insurers pay" column. Paying cash can cost less, but a cash payment usually does not count toward your deductible. Ask the hospital for both numbers before you book.

What it is

This is a first physical therapy evaluation of moderate complexity, typically about 30 minutes face to face. It is used when the problem is changing or other health conditions affect the plan of care.

What the price covers

The price covers the evaluation, billed once per evaluation rather than in time units. Treatment on the same day, such as therapeutic exercise or manual therapy, is billed separately in 15-minute units.