go back

Occupational Therapy, Self-Care Training

North Carolina rates for HCPCS 97535

An occupational therapist works one-on-one with a patient to build or relearn skills needed for daily activities such as dressing, bathing, cooking, or managing a household. This is billed in 15-minute increments and is often used after an injury, surgery, or illness that affects a person's ability to manage everyday tasks.

Rates data updated July 2026.

How much does Occupational Therapy, Self-Care Training cost?

$26.92

Typical negotiated rate. In North Carolina, July 2026.

Insurers have agreed to pay about $26.92 for this service. The price depends on where it is billed: about $25.12 from a physician practice, and about $39.81 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$25.12$21.88 to $30.90
FacilityA hospital or hospital-owned outpatient department$39.81$27.54 to $61.66

How much rates vary

Facilitymedian $40 · 10th to 90th $28 to $98Professionalmedian $25 · 10th to 90th $19 to $56
$20$50$100$200facility $40professional $25

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$27.54
Median
$48.98
Typical High
$97.72
Aetna
Setting
Facility
Modifier
CO · OT assistant
Typical Low
$56.23
Median
$56.23
Typical High
$56.23
Aetna
Setting
Facility
Modifier
CQ · PT assistant
Typical Low
$45.71
Median
$57.54
Typical High
$57.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$15.85
Median
$26.30
Typical High
$56.23
Aetna
Setting
Professional
Modifier
CO · OT assistant
Typical Low
$28.84
Median
$28.84
Typical High
$28.84
Aetna
Setting
Professional
Modifier
CQ · PT assistant
Typical Low
$58.88
Median
$58.88
Typical High
$58.88
BCBS
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$56.23
Typical High
$75.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$21.88
Median
$25.12
Typical High
$40.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$53.70
Typical High
$186.21
Cigna
Setting
Facility
Modifier
CO · OT assistant
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Cigna
Setting
Facility
Modifier
CQ · PT assistant
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
Cigna
Setting
Professional
Modifier
Global
Typical Low
$23.44
Median
$27.54
Typical High
$47.86
Medcost
Setting
Facility
Modifier
Global
Typical Low
$22.91
Median
$31.62
Typical High
$56.23
Medcost
Setting
Professional
Modifier
Global
Typical Low
$24.55
Median
$24.55
Typical High
$24.55
United
Setting
Facility
Modifier
Global
Typical Low
$15.14
Median
$38.90
Typical High
$53.70
United
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$33.11
Typical High
$51.29
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Wellcare
Setting
Facility
Modifier
CO · OT assistant
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Wellcare
Setting
Facility
Modifier
CQ · PT assistant
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$269.15
Typical High
$269.15

Where North Carolina sits

The same service costs 2.6 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

North Carolina· 35th of 51

$26.92

AK $58.88DE $22.39

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.