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New Mexico 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 $54 · 10th–90th $36–$1150%10%10th90th$54$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 / $53.70 / $120.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $46.77
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $48.98 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $66.07 / $91.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $107.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $66.07 / $91.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $63.10 / $79.43