go back

Occupational Therapy Evaluation, Low Complexity

Connecticut 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 $309 · 10th–90th $91$4170%10%20%10th90th$309Professionalmedian $74 · 10th–90th $54$1150%10%10th90th$74$50.0$100.0$200.0$500.0

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
$91.20
Median
$323.59
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$70.79
Typical High
$100.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$213.80
Typical High
$316.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$91.20
Typical High
$186.21
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$107.15
Typical High
$109.65
Health New England
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$257.04
Typical High
$354.81
Health New England
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$85.11
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$117.49