Where is this data coming from?

This data represents aggregated & anonymized data across PT, OT and SLP practices on StrataPT's EMR & RCM platforms.

What do the dashed lines represent?

We use dashed lines to represent data that is likely to change quite often.

What is the average First Pass Clean Claim Rate in North Carolina?

The average First Pass Clean Claim Rate in North Carolina is 87.36% for physical therapy, occupational therapy and speech language therapy practices.

What is the average Denial Rate in North Carolina?

The average Denial Rate in North Carolina is 9.91% for physical therapy, occupational therapy and speech language therapy practices.

What is the average Reimbursement per Visit in North Carolina?

The expected Reimbursement Per Visit in North Carolina is $75.07 for physical therapy, occupational therapy and speech language therapy practices.

What is BCBS of North Carolina's average Reimbursement per Visit in North Carolina?

The expected Reimbursement Per Visit in North Carolina is $109.30 for physical therapy, occupational therapy and speech language therapy practices.

BCBS of North Carolina Reimbursement Rates

Accepting BCBS of North Carolina shouldn't be mysterious. We share our aggregate data -- whether you're a client of ours or not.

BCBS of North Carolina Reimbursement Rates for Physical Therapy Practices in North Carolina

Physical Therapy Practice Benchmarks in North Carolina

Average Reimbursement Per Visit

While negotiated reimbursement rates between BCBS of North Carolina and a healthcare provider are confidential, we can give you a general sense for BCBS of North Carolina's reimbursement rates by looking at the aggregate data across StrataPT's customers.

$109.30

Latest

$120.46

Expected

$109.30

High

$174.81

Mean

$125.58

Low

$94.75

Median

$121.73

Recent Visit CPT Code Combinations

Data refreshed 23 hours ago

Codes and Units	Units	Total Reimbursement	Average Per Unit
97112 x 4 (No Assistant) Units 4 units @ $26.78 average per unit Reimbursement $107.14 total reimbursement	4	$107.14	$26.78
97112 x 1 (No Assistant), 97530 x 3 (No Assistant) Units 4 units @ $31.26 average per unit Reimbursement $125.03 total reimbursement	4	$125.03	$31.26
97110 x 2 (No Assistant), 97530 x 2 (No Assistant) Units 4 units @ $30.10 average per unit Reimbursement $120.40 total reimbursement	4	$120.40	$30.10
97112 x 1 (No Assistant), 97162 x 1 (No Assistant) Units 2 units @ $53.73 average per unit Reimbursement $107.45 total reimbursement	2	$107.45	$53.73
97110 x 4 (No Assistant) Units 4 units @ $26.87 average per unit Reimbursement $107.46 total reimbursement	4	$107.46	$26.87
97110 x 2 (Assistant), 97140 x 2 (Assistant) Units 4 units @ $30.59 average per unit Reimbursement $122.37 total reimbursement	4	$122.37	$30.59
92507 x 1 (No Assistant) Units 1 units @ $88.27 average per unit Reimbursement $88.27 total reimbursement	1	$88.27	$88.27
97112 x 2 (No Assistant), 97530 x 2 (No Assistant) Units 4 units @ $27.99 average per unit Reimbursement $111.97 total reimbursement	4	$111.97	$27.99
97530 x 4 (No Assistant) Units 4 units @ $34.53 average per unit Reimbursement $138.11 total reimbursement	4	$138.11	$34.53
97112 x 3 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $27.62 average per unit Reimbursement $110.50 total reimbursement	4	$110.50	$27.62
97110 x 1 (No Assistant), 97112 x 3 (No Assistant) Units 4 units @ $31.67 average per unit Reimbursement $126.68 total reimbursement	4	$126.68	$31.67
97110 x 2 (No Assistant), 97112 x 2 (No Assistant) Units 4 units @ $25.18 average per unit Reimbursement $100.72 total reimbursement	4	$100.72	$25.18
97110 x 1 (No Assistant), 97530 x 3 (No Assistant) Units 4 units @ $27.06 average per unit Reimbursement $108.24 total reimbursement	4	$108.24	$27.06
97032 x 1 (Assistant), 97110 x 2 (Assistant), 97140 x 1 (Assistant) Units 4 units @ $26.61 average per unit Reimbursement $106.42 total reimbursement	4	$106.42	$26.61

Top Healthcare Payers in North Carolina

BCBS of North Carolina: $109.30
paid in 27 days
Aetna: $108.19
paid in 7 days
Medicare of North Carolina: $95.72
paid in 22 days
Humana: $93.82
paid in 11 days

All rights reserved. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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