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Occupational Therapy Evaluation, Low Complexity

Rhode Island 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 October 2026.

How much does Occupational Therapy Evaluation, Low Complexity cost?

$83.18

Typical physician fee. In Rhode Island, October 2026.

Insurers have agreed to pay about $83.18 for this service. Most negotiated rates run $74.13 to $105.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $214 · 10th to 90th $141 to $12,303Professionalmedian $81 · 10th to 90th $72 to $107
$100$200$500$1K$2K$5K$10Kfacility $214professional $81

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$74.13
Typical High
$74.13
BCBS Rhode Island
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$218.78
Typical High
$12,302.69
BCBS Rhode Island
Setting
Professional
Modifier
None
Typical Low
$72.44
Median
$104.71
Typical High
$104.71
BCBS Rhode Island
Setting
Professional
Modifier
EP · Child screening program
Typical Low
$162.18
Median
$234.42
Typical High
$234.42
Cigna
Setting
Professional
Modifier
None
Typical Low
$77.62
Median
$107.15
Typical High
$138.04
United
Setting
Facility
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Professional
Modifier
None
Typical Low
$69.18
Median
$85.11
Typical High
$120.23

Where Rhode Island sits

The same service costs 3.3 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Rhode Island· 32nd of 51

$83.18

AK $200FL $60.26

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.