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Occupational Therapy Evaluation, High Complexity

Hawaii 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 $100 · 10th–90th $72$1480%10%10th90th$100$50.0$100.0$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
$69.18
Median
$83.18
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$109.65
Typical High
$128.82
HMSA
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$117.49
Typical High
$147.91
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$128.82
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$102.33
Typical High
$147.91
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$123.03
Typical High
$186.21