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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.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $52.48 / $213.80
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $61.66 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $75.86 / $181.97
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $44.67 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $60.26 / $104.71
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $67.61 / $117.49
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $77.62 / $131.83
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $588.84 / $588.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $97.72
Optum
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $30.90 / $39.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $60.26 / $125.89
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $208.93 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $64.57 / $131.83