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Wisconsin 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 $58 · 10th–90th $42–$1740%10%10th90th$58$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
$39.81 / $53.70 / $85.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $56.23 / $173.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $95.50 / $208.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $204.17
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $63.10 / $436.52
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $81.28 / $169.82
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $144.54 / $223.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $309.03 / $436.52
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $151.36 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $169.82