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Occupational Therapy Evaluation, Low Complexity

Vermont 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 $269 · 10th–90th $115$3980%20%10th90th$269Professionalmedian $72 · 10th–90th $48$1020%10%20%10th90th$72$50.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$316.23
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$69.18
Typical High
$83.18
BCBS
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$269.15
Typical High
$398.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$100.00
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$138.04
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$109.65
Typical High
$213.80