go back

Michigan 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 $52 · 10th–90th $37–$720%10%20%10th90th$52$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
$36.31 / $48.98 / $66.07
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $64.57 / $64.57
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $58.88 / $158.49
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $54.95 / $112.20
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $52.48 / $83.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $54.95 / $70.79