go back

Occupational Therapy Evaluation, Low Complexity

New Jersey 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 $162 · 10th–90th $56$6170%10%10th90th$162Professionalmedian $71 · 10th–90th $54$1150%20%10th90th$71$50.0$100.0$200.0$500.0$1.0K

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
$56.23
Median
$162.18
Typical High
$616.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$69.18
Typical High
$112.20
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$169.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$87.10
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$117.49
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$81.28
Typical High
$120.23
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$91.20
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$79.43
Typical High
$114.82