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Occupational Therapy Evaluation, High Complexity

Montana 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 October 2026.

How much does Occupational Therapy Evaluation, High Complexity cost?

$135

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $135 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $174 from a hospital or other facility.

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.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$135$105 to $158
FacilityA hospital or hospital-owned outpatient department$174$170 to $186

How much rates vary

Facilitymedian $174 · 10th to 90th $158 to $200Professionalmedian $135 · 10th to 90th $91 to $162
$100$200facility $174professional $135

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
None
Typical Low
$67.61
Median
$89.13
Typical High
$165.96
BCBS Montana
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Cigna
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$190.55
Cigna
Setting
Professional
Modifier
None
Typical Low
$128.82
Median
$134.90
Typical High
$144.54
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$173.78
Typical High
$199.53
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$112.20
Median
$169.82
Typical High
$181.97
Providence
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$158.49
Typical High
$190.55
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$134.90
Typical High
$162.18
United
Setting
Professional
Modifier
None
Typical Low
$81.28
Median
$93.33
Typical High
$93.33

Where Montana sits

The same service costs 3.3 times more in Alaska than in Florida. 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.

Montana· 4th of 51

$135

AK $200FL $60.26

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.