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Occupational Therapy Evaluation, High Complexity

Iowa 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 $91 · 10th–90th $63$3720%10%20%10th90th$91$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
$63.10
Median
$81.28
Typical High
$489.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$109.65
Typical High
$154.88
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$134.90
Typical High
$275.42
Medica
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$104.71
Typical High
$281.84
Midlands
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$154.88
Typical High
$288.40
Midlands
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$131.83
Typical High
$204.17
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$87.10
Typical High
$173.78
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$151.36