go back

Tennessee 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 $36$870%10%10th90th$49$20.0$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
$36.31 / $46.77 / $70.79
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $51.29 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $58.88 / $100.00
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $588.84 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $54.95 / $66.07