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Occupational Therapy Evaluation, High Complexity

New Mexico 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 $78 · 10th–90th $48$1660%10%10th90th$78$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
$47.86
Median
$74.13
Typical High
$239.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$93.33
Typical High
$114.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$138.04
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$144.54
Providence
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$95.50
Typical High
$138.04
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$123.03