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Occupational Therapy Evaluation, High Complexity

New Jersey 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.

Professionalmedian $72 · 10th–90th $52$1510%10%20%10th90th$72$50.0$100.0$200.0$500.0$1.0K

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
$50.12
Median
$69.18
Typical High
$177.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$87.10
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$117.49
Typical High
$117.49
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$117.49
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$79.43
Typical High
$114.82