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Occupational Therapy Evaluation, Moderate Complexity

Maine 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 $126 · 10th–90th $95$3390%20%10th90th$126Professionalmedian $85 · 10th–90th $48$1950%10%10th90th$85$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
$95.50
Median
$125.89
Typical High
$177.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$66.07
Typical High
$95.50
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$102.33
Typical High
$186.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$63.10
Median
$63.10
Typical High
$63.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$109.65
Typical High
$234.42
Community Health Options
Setting
Facility
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$134.90
Typical High
$208.93
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$123.03
Typical High
$177.83
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$79.43
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$109.65
Typical High
$199.53