go back

Occupational Therapy Evaluation, High Complexity

Illinois 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 $81 · 10th–90th $59$1350%10%20%10th90th$81$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
$53.70
Median
$74.13
Typical High
$100.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$100.00
Typical High
$134.90
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$87.10
Typical High
$158.49
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$144.54
Typical High
$245.47
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$134.90
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$83.18
Typical High
$151.36