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Massachusetts 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 $62 · 10th–90th $39–$1700%5%10%10th90th$62$50.0$100.0$200.0

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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $50.12 / $120.23
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $79.43 / $194.98
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $60.26 / $181.97
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $60.26 / $112.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $83.18 / $181.97
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $79.43 / $194.98
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $64.57 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $72.44 / $190.55