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Occupational Therapy Evaluation, Low Complexity

Florida 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 $182 · 10th–90th $52$3390%10%10th90th$182Professionalmedian $69 · 10th–90th $52$1000%10%10th90th$69$10.0$20.0$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
$52.48
Median
$162.18
Typical High
$338.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$67.61
Typical High
$95.50
AvMed
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$81.28
Typical High
$102.33
AvMed
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$97.72
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$54.95
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$72.44
Typical High
$134.90
Florida Blue
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$181.97
Typical High
$186.21
Florida Blue
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$69.18
Typical High
$89.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$100.00
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$66.07
Typical High
$104.71
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$102.33