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New Jersey 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 $49 · 10th–90th $35–$930%10%20%10th90th$49$50.0$100.0$200.0$500.0

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 / $46.77 / $102.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $53.70 / $87.10
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $56.23 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $57.54 / $85.11