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Occupational Therapy Evaluation, Low Complexity

Nationwide rates for HCPCS 97165

An occupational therapist assesses how a health condition, injury, or developmental issue affects a person's ability to manage everyday tasks like dressing, bathing, or working, then puts together a plan of care. This version applies to more straightforward cases, where the health history and the number of affected daily activities are relatively limited.

Rates data updated July 2026.

Facilitymedian $123 · 10th–90th $69$3390%10%20%10th90th$123Professionalmedian $83 · 10th–90th $56$2340%20%10th90th$83$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$134.90
Typical High
$346.74
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$74.13
Typical High
$213.80
BCBS
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$239.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$81.28
Typical High
$147.91
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$109.65
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$81.28
Typical High
$154.88