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Occupational Therapy Evaluation, Low Complexity

Idaho 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 $117 · 10th–90th $89$2040%10%20%10th90th$117Professionalmedian $93 · 10th–90th $72$1780%20%40%10th90th$93$50.0$100.0$200.0

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
$95.50
Median
$114.82
Typical High
$165.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$93.33
Typical High
$165.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$151.36
Typical High
$223.87
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$194.98
Typical High
$213.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$75.86
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$141.25
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$100.00
Typical High
$181.97
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$199.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$223.87
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$109.65
Typical High
$147.91
Select Health
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$117.49
Typical High
$213.80
Select Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$107.15
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$93.33