Occupational Therapy Evaluation, High Complexity

Delaware 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.

How much does Occupational Therapy Evaluation, High Complexity cost?

$66.07

Typical physician fee. In Delaware, July 2026.

Insurers have agreed to pay about $66.07 for this service. Most negotiated rates run $52.48 to $77.62.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $66 · 10th to 90th $48 to $95

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Professional Modifier Global Typical Low $47.86 Median $63.10 Typical High $77.62	Professional	Global	$47.86	$63.10	$77.62
Cigna Setting Professional Modifier Global Typical Low $60.26 Median $93.33 Typical High $114.82	Professional	Global	$60.26	$93.33	$114.82
United Setting Professional Modifier Global Typical Low $64.57 Median $89.13 Typical High $208.93	Professional	Global	$64.57	$89.13	$208.93

Where Delaware sits

The same service costs 2.8 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Delaware· 50th of 51

$66.07

AK $186KY $66.07

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.