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Occupational Therapy Evaluation, High Complexity

Ohio 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$1290%10%10th90th$74$1.0$5.0$20.0$100.0$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
$53.70
Median
$66.07
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$85.11
Typical High
$144.54
CareSource
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$100.00
Typical High
$128.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$91.20
Typical High
$154.88
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$91.20
Typical High
$154.88
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$77.62
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$117.49
Typical High
$190.55
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$79.43
Typical High
$109.65