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Occupational Therapy Evaluation, High Complexity

Oregon 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?

$123

Typical physician fee. In Oregon, July 2026.

Insurers have agreed to pay about $123 for this service. Most negotiated rates run $83.18 to $204.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $123 · 10th to 90th $68 to $275
$50$100$200$500professional $123

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
$47.86
Median
$89.13
Typical High
$331.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$107.15
Typical High
$263.03
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$208.93
Typical High
$257.04
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$251.19
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$134.90
Typical High
$251.19
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$154.88
Typical High
$295.12
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$181.97

Where Oregon 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.

Oregon· 6th of 51

$123

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.