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Occupational Therapy Evaluation, High Complexity

Colorado 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 $74 · 10th–90th $52$1050%10%20%10th90th$74$2.0$10.0$50.0$200.0

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
Professional
Modifier
Global
Typical Low
$52.48
Median
$74.13
Typical High
$102.33
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$97.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$67.61
Typical High
$134.90
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$162.18
Typical High
$181.97
Select Health
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$104.71