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Occupational Therapy Evaluation, High Complexity

Vermont 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 $69 · 10th–90th $48$850%10%20%10th90th$69$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
$69.18
Typical High
$83.18
BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$100.00
Cigna
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$93.33
Typical High
$138.04
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$125.89
Typical High
$371.54
United
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$112.20
Typical High
$213.80