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Occupational Therapy Evaluation, High Complexity

Nationwide rates for HCPCS 97167

This is a thorough evaluation performed by an occupational therapist to assess a patient's ability to perform daily activities, such as dressing, cooking, or work tasks, when the patient's condition involves multiple complicating factors. It typically includes a detailed history, standardized assessments, and clinical judgment to develop a treatment plan for a patient with a more complex presentation than a routine evaluation. This level reflects more time and clinical complexity than a basic evaluation.

Rates data updated July 2026.

Professionalmedian $81 · 10th–90th $55$2000%20%10th90th$81$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
Professional
Modifier
Global
Typical Low
$53.70
Median
$70.79
Typical High
$147.91
BCBS
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$81.28
Typical High
$147.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$89.13
Typical High
$165.96
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$81.28
Typical High
$154.88