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Occupational Therapy Evaluation, Low Complexity

Georgia 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 $95 · 10th–90th $65$2820%20%10th90th$95Professionalmedian $76 · 10th–90th $59$1200%10%20%10th90th$76$1.0$5.0$20.0$100.0$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
$64.57
Median
$95.50
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$70.79
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$89.13
Typical High
$144.54
CareSource
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$100.00
Typical High
$131.83
CareSource
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$70.79
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$83.18
Typical High
$158.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$269.15
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$100.00
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$89.13
Typical High
$134.90