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Occupational Therapy Evaluation, High Complexity

Maryland 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 $74 · 10th–90th $54$1260%20%10th90th$74$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$69.18
Typical High
$125.89
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$91.20
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$85.11
Typical High
$138.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$151.36
United
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$93.33
Typical High
$112.20
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$104.71
Typical High
$154.88