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Occupational Therapy Evaluation, High Complexity

South Carolina 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 $71 · 10th–90th $58$1000%20%10th90th$71$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
$60.26
Median
$70.79
Typical High
$95.50
BCBS
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$66.07
Typical High
$114.82
Cigna
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$74.13
Typical High
$107.15
Medcost
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$79.43
Typical High
$97.72