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New York 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
$31.45 / $45.73 / $124.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.40 / $67.40 / $108.59
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.05 / $60.05 / $60.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.48 / $61.47 / $95.74
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $110.00
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.47 / $67.37 / $122.85
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.11 / $57.11 / $57.11
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.34 / $71.91 / $147.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.58 / $61.42 / $118.02
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.59 / $76.51 / $149.38