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Occupational Therapy Evaluation, Moderate Complexity

Connecticut 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 $302 · 10th–90th $102$4070%20%10th90th$302Professionalmedian $74 · 10th–90th $54$1150%10%10th90th$74$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$316.23
Typical High
$407.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$70.79
Typical High
$100.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$213.80
Typical High
$316.23
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$123.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$91.20
Typical High
$186.21
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$107.15
Typical High
$109.65
Health New England
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$269.15
Typical High
$389.05
Health New England
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$85.11
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$117.49