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Occupational Therapy Evaluation, Low Complexity

Virginia 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 $95 · 10th–90th $60$2090%10%10th90th$95Professionalmedian $79 · 10th–90th $59$1260%10%10th90th$79$50.0$200.0$1.0K$5.0K

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
$60.26
Median
$95.50
Typical High
$208.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$74.13
Typical High
$120.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$87.10
Typical High
$123.03
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$97.72
Typical High
$199.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$120.23
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$85.11
Typical High
$154.88
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$125.89
Medcost
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Medcost
Setting
Facility
Modifier
Global
Typical Low
$57.54
Median
$83.18
Typical High
$131.83
Medcost
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Sentara
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$100.00
Typical High
$389.05
Sentara
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$100.00
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$109.65
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$87.10
Typical High
$114.82