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California 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 $59 · 10th–90th $41–$2040%10%10th90th$59$20.0$50.0$100.0$200.0$500.0$1.0K

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
$40.74 / $53.70 / $213.80
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $75.86 / $181.97
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $44.67 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $60.26 / $120.23
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $67.61 / $117.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $77.62 / $134.90
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $588.84 / $588.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $97.72
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $39.81 / $70.79
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $60.26 / $125.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $63.10 / $141.25