go back

Occupational Therapy Evaluation, Low Complexity

Washington 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 $79$2880%10%10th90th$141Professionalmedian $93 · 10th–90th $59$3160%10%10th90th$93$50.0$100.0$200.0$500.0$1.0K

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
$93.33
Median
$181.97
Typical High
$416.87
Aetna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$91.20
Typical High
$380.19
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$288.40
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$218.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$109.65
Typical High
$154.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$257.04
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$107.15
Typical High
$257.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$107.15
Typical High
$229.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$67.61
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$204.17
Typical High
$204.17
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$331.13
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$173.78
Typical High
$251.19
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$151.36
Typical High
$288.40
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$104.71
Typical High
$194.98
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$109.65
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$239.88
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$114.82
Typical High
$218.78