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Occupational Therapy Evaluation, High Complexity

Georgia 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 $76 · 10th–90th $59$1120%10%20%10th90th$76$1.0$5.0$20.0$100.0$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
$56.23
Median
$70.79
Typical High
$100.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$141.25
CareSource
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$131.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$56.23
Median
$85.11
Typical High
$158.49
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$120.23
Typical High
$275.42
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$87.10
Typical High
$134.90