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Occupational Therapy Evaluation, Low Complexity

South Dakota 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 $132 · 10th–90th $85$2290%10%10th90th$132Professionalmedian $95 · 10th–90th $68$1860%10%20%10th90th$95$100.0$200.0$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
$91.20
Median
$147.91
Typical High
$147.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$72.44
Typical High
$97.72
Avera
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$120.23
Typical High
$134.90
Avera
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$112.20
Medica
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$125.89
Typical High
$331.13
Medica
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$295.12
Midlands
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$128.82
Typical High
$151.36
Midlands
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$173.78
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$147.91
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$91.20
Typical High
$229.09
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$134.90
Typical High
$158.49