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Occupational Therapy Evaluation, Moderate Complexity

Nationwide rates for HCPCS 97166

An occupational therapist assesses how a health condition, injury, or developmental issue is affecting a person's ability to perform everyday tasks like dressing, cooking, or working, then creates a plan of care. This version reflects a moderately complex case, with a somewhat more involved health history and a moderate number of areas affecting daily function compared to a more straightforward evaluation.

Rates data updated July 2026.

Facilitymedian $123 · 10th–90th $69$3630%10%20%10th90th$123Professionalmedian $81 · 10th–90th $56$2140%20%10th90th$81$0.5$5.0$50.0$500.0$5.0K$50.0K

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
$66.07
Median
$134.90
Typical High
$380.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$74.13
Typical High
$173.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$95.50
Typical High
$239.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$81.28
Typical High
$147.91
Cigna
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$79.43
Typical High
$338.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$109.65
Typical High
$158.49
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$81.28
Typical High
$158.49