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Occupational Therapy Evaluation, Low Complexity

Kentucky 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 $83 · 10th–90th $66$1660%20%10th90th$83Professionalmedian $66 · 10th–90th $47$1070%10%20%10th90th$66$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
$66.07
Median
$107.15
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$67.61
Typical High
$128.82
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$123.03
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$61.66
Typical High
$75.86
CareSource
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$112.20
Typical High
$138.04
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$112.20
Typical High
$141.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$107.15
Typical High
$489.78
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$47.86
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$79.43
Typical High
$109.65