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Occupational Therapy Evaluation, High Complexity

Connecticut 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 $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
Professional
Modifier
Global
Typical Low
$52.48
Median
$70.79
Typical High
$100.00
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$77.62
Typical High
$120.23
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$91.20
Typical High
$186.21
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$107.15
Typical High
$109.65
United
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$89.13
Typical High
$120.23