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 South Carolina?

The average First Pass Clean Claim Rate in South Carolina is 97.67% for physical therapy, occupational therapy and speech language therapy practices.

What is the average Denial Rate in South Carolina?

The average Denial Rate in South Carolina is 7.69% for physical therapy, occupational therapy and speech language therapy practices.

What is the average Reimbursement per Visit in South Carolina?

The expected Reimbursement Per Visit in South Carolina is $96.60 for physical therapy, occupational therapy and speech language therapy practices.

What is Aetna's average Reimbursement per Visit in South Carolina?

The expected Reimbursement Per Visit in South Carolina is $93.15 for physical therapy, occupational therapy and speech language therapy practices.

Aetna Reimbursement Rates in South Carolina

Aetna Reimbursement Rates for Physical Therapy Practices in South Carolina

Physical Therapy Practice Benchmarks in South Carolina

Average Reimbursement Per Visit

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

$93.15

Latest

$95.41

Expected

$93.15

High

$107.83

Mean

$92.46

Low

$81.98

Median

$92.15

Recent Visit CPT Code Combinations

Data refreshed 1 day ago

Codes and Units	Units	Total Reimbursement	Average Per Unit
97110 x 1 (Assistant), 97112 x 1 (Assistant), 97530 x 1 (No Assistant), 97530 x 1 (Assistant) Units 4 units @ $25.13 average per unit Reimbursement $100.51 total reimbursement	4	$100.51	$25.13
97530 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $21.89 average per unit Reimbursement $87.57 total reimbursement	4	$87.57	$21.89
97112 x 1 (Assistant), 97112 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (Assistant) Units 4 units @ $26.41 average per unit Reimbursement $105.62 total reimbursement	4	$105.62	$26.41
97110 x 1 (Assistant), 97112 x 1 (Assistant), 97116 x 1 (Assistant), 97530 x 1 (Assistant) Units 4 units @ $24.87 average per unit Reimbursement $99.49 total reimbursement	4	$99.49	$24.87
97110 x 1 (No Assistant), 97112 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $25.67 average per unit Reimbursement $102.67 total reimbursement	4	$102.67	$25.67
97110 x 1 (No Assistant), 97110 x 1 (No Assistant), 97140 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $18.07 average per unit Reimbursement $72.27 total reimbursement	4	$72.27	$18.07
97110 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $20.59 average per unit Reimbursement $82.35 total reimbursement	4	$82.35	$20.59
97110 x 2 (Assistant), 97112 x 1 (Assistant), 97140 x 1 (Assistant) Units 4 units @ $17.90 average per unit Reimbursement $71.59 total reimbursement	4	$71.59	$17.90
97110 x 1 (Assistant), 97112 x 2 (Assistant), 97140 x 1 (Assistant) Units 4 units @ $21.62 average per unit Reimbursement $86.47 total reimbursement	4	$86.47	$21.62
97110 x 1 (Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (Assistant) Units 4 units @ $18.14 average per unit Reimbursement $72.55 total reimbursement	4	$72.55	$18.14
97140 x 1 (No Assistant), 97530 x 3 (No Assistant) Units 4 units @ $19.04 average per unit Reimbursement $76.15 total reimbursement	4	$76.15	$19.04
92507 x 1 (No Assistant) Units 1 units @ $62.20 average per unit Reimbursement $62.20 total reimbursement	1	$62.20	$62.20
97112 x 1 (No Assistant), 97112 x 1 (Assistant), 97530 x 1 (Assistant), 97530 x 1 (No Assistant) Units 4 units @ $26.42 average per unit Reimbursement $105.68 total reimbursement	4	$105.68	$26.42
97110 x 2 (Assistant), 97530 x 2 (Assistant) Units 4 units @ $17.69 average per unit Reimbursement $70.75 total reimbursement	4	$70.75	$17.69
97110 x 2 (No Assistant), 97530 x 2 (No Assistant) Units 4 units @ $19.45 average per unit Reimbursement $77.78 total reimbursement	4	$77.78	$19.45
97110 x 2 (No Assistant), 97112 x 1 (No Assistant), 97140 x 1 (No Assistant) Units 4 units @ $17.54 average per unit Reimbursement $70.16 total reimbursement	4	$70.16	$17.54
97110 x 1 (Assistant), 97112 x 1 (Assistant), 97530 x 1 (Assistant), 97750 x 1 (Assistant) Units 4 units @ $25.43 average per unit Reimbursement $101.74 total reimbursement	4	$101.74	$25.43
97110 x 1 (Assistant), 97110 x 1 (No Assistant), 97530 x 1 (Assistant), 97530 x 1 (No Assistant) Units 4 units @ $19.01 average per unit Reimbursement $76.02 total reimbursement	4	$76.02	$19.01
97110 x 1 (Assistant), 97112 x 2 (Assistant), 97530 x 1 (Assistant) Units 4 units @ $18.81 average per unit Reimbursement $75.26 total reimbursement	4	$75.26	$18.81
97110 x 2 (Assistant), 97112 x 2 (Assistant) Units 4 units @ $24.32 average per unit Reimbursement $97.28 total reimbursement	4	$97.28	$24.32
97110 x 1 (No Assistant), 97112 x 1 (No Assistant), 97140 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $22.62 average per unit Reimbursement $90.48 total reimbursement	4	$90.48	$22.62
97110 x 1 (Assistant), 97110 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (Assistant) Units 4 units @ $19.39 average per unit Reimbursement $77.56 total reimbursement	4	$77.56	$19.39
97140 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $20.94 average per unit Reimbursement $83.75 total reimbursement	4	$83.75	$20.94
97110 x 1 (No Assistant), 97140 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $18.28 average per unit Reimbursement $73.11 total reimbursement	4	$73.11	$18.28
97110 x 1 (No Assistant), 97110 x 1 (No Assistant), 97112 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $24.87 average per unit Reimbursement $99.46 total reimbursement	4	$99.46	$24.87
97110 x 1 (No Assistant), 97110 x 1 (No Assistant), 97530 x 1 (No Assistant), 97530 x 1 (No Assistant) Units 4 units @ $19.92 average per unit Reimbursement $79.69 total reimbursement	4	$79.69	$19.92
97110 x 1 (Assistant), 97112 x 1 (No Assistant), 97112 x 1 (Assistant), 97530 x 1 (Assistant), 97530 x 1 (No Assistant) Units 5 units @ $25.26 average per unit Reimbursement $126.32 total reimbursement	5	$126.32	$25.26

Top Healthcare Payers in South Carolina

Medicare of South Carolina: $111.52
paid in 14 days
BCBS of South Carolina: $109.29
paid in 13 days
United Health Care: $105.00
paid in 16 days
Cigna - RPN: $100.37
paid in 50 days
Historical: $100.00
paid in NaN days
MedRisk: $99.17
paid in 45 days
Aetna: $93.15
paid in 9 days
Humana: $88.23
paid in 9 days
Tricare East: $86.97
paid in 7 days
Select Health of South Carolina: $80.90
paid in 46 days
Align Networks (One Call PT): $73.13
paid in 91 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.

Frequently Asked Questions

Aetna Reimbursement Rates in South Carolina

Aetna Reimbursement Rates for Physical Therapy Practices in South Carolina

Average Reimbursement Per Visit

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

Recent Visit CPT Code Combinations

Data refreshed 1 day ago

Top Healthcare Payers in South Carolina

Medicare of South Carolina

BCBS of South Carolina

United Health Care

Cigna - RPN

Historical

MedRisk

Aetna

Humana

Tricare East

Select Health of South Carolina

Align Networks (One Call PT)

Related:

Frequently Asked Questions

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Healthcare Payer Reimbursement Rates by State

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