go back

Occupational Therapy Evaluation, Low Complexity

Maryland 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 $89 · 10th–90th $58$3240%20%10th90th$89Professionalmedian $78 · 10th–90th $56$2400%20%10th90th$78$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$57.54
Median
$89.13
Typical High
$323.59
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$74.13
Typical High
$302.00
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$91.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$181.97
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$85.11
Typical High
$138.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$151.36
United
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$69.18
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$93.33
Typical High
$114.82
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$104.71
Typical High
$154.88