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Occupational Therapy Evaluation, Low Complexity

Indiana 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 $186 · 10th–90th $74$2690%10%10th90th$186Professionalmedian $74 · 10th–90th $52$1260%10%20%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
$74.13
Median
$194.98
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$70.79
Typical High
$104.71
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$83.18
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$77.62
Typical High
$141.25
CareSource
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$131.83
CareSource
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$114.82
Typical High
$134.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$109.65
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$93.33
Typical High
$154.88
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$109.65
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$83.18
Typical High
$131.83