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Occupational Therapy Evaluation, Low Complexity

Ohio 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 $141 · 10th–90th $63$2690%10%10th90th$141Professionalmedian $76 · 10th–90th $55$1450%10%10th90th$76$1.0$5.0$20.0$100.0$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
$60.26
Median
$125.89
Typical High
$269.15
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$69.18
Typical High
$141.25
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$87.10
Typical High
$147.91
Aultcare
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$134.90
Typical High
$134.90
Aultcare
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$67.61
Typical High
$77.62
CareSource
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$120.23
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$100.00
Typical High
$128.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$128.82
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$91.20
Typical High
$154.88
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$194.98
Typical High
$323.59
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$151.36
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$77.62
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$114.82
Typical High
$162.18
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$100.00
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$109.65