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Occupational Therapy Evaluation, Moderate Complexity

West Virginia 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 $93 · 10th–90th $93$1150%50%90th$93Professionalmedian $93 · 10th–90th $60$2140%10%20%10th90th$93$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
$93.33
Median
$93.33
Typical High
$102.33
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$93.33
Typical High
$213.80
CareSource
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$125.89
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$100.00
Typical High
$154.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$114.82
Typical High
$489.78
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$102.33
Typical High
$158.49
United
Setting
Facility
Modifier
Global
Typical Low
$81.28
Median
$83.18
Typical High
$147.91
United
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$87.10
Typical High
$131.83