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Occupational Therapy Evaluation, Low Complexity

New Mexico 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 $148 · 10th–90th $76$1,1480%10%10th90th$148Professionalmedian $89 · 10th–90th $48$2400%20%10th90th$89$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$114.82
Median
$147.91
Typical High
$177.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$81.28
Typical High
$316.23
BCBS
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$724.44
Typical High
$1,258.93
BCBS
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$93.33
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$75.86
Typical High
$89.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$138.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$144.54
Providence
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$114.82
Providence
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$138.04
United
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$100.00
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$123.03