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Occupational Therapy Evaluation, High Complexity

Washington 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.

Professionalmedian $91 · 10th–90th $58$2510%10%10th90th$91$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
$87.10
Typical High
$331.13
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$104.71
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$257.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$107.15
Typical High
$234.42
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$67.61
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$173.78
Typical High
$251.19
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$104.71
Typical High
$194.98
United
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$93.33
Typical High
$223.87
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$114.82
Typical High
$218.78