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Occupational Therapy Evaluation, Low Complexity

Washington, DC 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 $240 · 10th–90th $78$4790%20%10th90th$240Professionalmedian $78 · 10th–90th $55$1120%50%10th90th$78$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$77.62
Median
$239.88
Typical High
$478.63
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$75.86
Typical High
$77.62
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$165.96
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$79.43
Typical High
$239.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$181.97
United
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$234.42