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Occupational Therapy Evaluation, Low Complexity

New Hampshire 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 $112 · 10th–90th $62$3800%20%40%10th90th$112Professionalmedian $100 · 10th–90th $60$2190%10%10th90th$100$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
$61.66
Median
$112.20
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$64.57
Typical High
$95.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$100.00
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$93.33
Typical High
$204.17
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$162.18
Typical High
$239.88
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$218.78
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$89.13
Typical High
$123.03
Well Sense
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$58.88
Typical High
$58.88