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Occupational Therapy Evaluation, High Complexity

Michigan 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.

How much does Occupational Therapy Evaluation, High Complexity cost?

$74.13

Typical physician fee. In Michigan, July 2026.

Insurers have agreed to pay about $74.13 for this service. Most negotiated rates run $63.10 to $83.18.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $74 · 10th to 90th $54 to $93
$50$100$200professional $74

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$70.79
Typical High
$85.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$93.33
Cigna
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$81.28
Typical High
$234.42
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$79.43
Typical High
$125.89
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$87.10
Typical High
$269.15
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$107.15

Where Michigan sits

The same service costs 2.8 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Michigan· 34th of 51

$74.13

AK $186KY $66.07

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.