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Occupational Therapy Evaluation, High Complexity

Idaho 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 $93 · 10th–90th $74$1910%20%40%10th90th$93$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
$74.13
Median
$91.20
Typical High
$158.49
BCBS
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$194.98
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$141.25
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$169.82
Typical High
$199.53
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$109.65
Typical High
$147.91
Select Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$107.15
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$93.33