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Nationwide rates for HCPCS 97168

Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and A revised plan of care. A formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required. Typically, 30 minutes are spent face-to-face with the patient and/or family.

Professionalmedian $55 · 10th–90th $38$1320%20%10th90th$55$0.2$2.0$20.0$200.0$2.0K$20.0K

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $51.29 / $112.20
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $58.88 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $60.26 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $56.23 / $104.71