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Occupational Therapy Evaluation, Low Complexity

Michigan 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 $76$1910%20%10th90th$83Professionalmedian $76 · 10th–90th $55$1100%20%10th90th$76$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
$75.86
Median
$79.43
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$74.13
Typical High
$102.33
BCBS
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$141.25
Typical High
$181.97
BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$93.33
Typical High
$93.33
CareSource
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$120.23
Cigna
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$81.28
Typical High
$234.42
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$199.53
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$79.43
Typical High
$134.90
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$87.10
Typical High
$269.15
United
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$100.00
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$109.65