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Occupational Therapy Evaluation, High Complexity

Utah 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 $89 · 10th–90th $56$3310%10%20%10th90th$89$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
$56.23
Median
$85.11
Typical High
$331.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$93.33
Typical High
$190.55
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$229.09
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$120.23
Select Health
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$104.71
Typical High
$117.49
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$138.04
Typical High
$218.78
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$91.20
Typical High
$102.33