go back

South Dakota 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 $63 · 10th–90th $43–$1230%10%10th90th$63$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
$42.66 / $61.66 / $67.61
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $75.86 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $75.86 / $77.62
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $151.36
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $89.13 / $104.71
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $114.82
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $97.72 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $61.66 / $151.36
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $97.72 / $114.82