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Occupational Therapy, Self-Care Training

Virginia 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?

$27.54

Typical negotiated rate. In Virginia, July 2026.

Insurers have agreed to pay about $27.54 for this service. The price depends on where it is billed: about $25.70 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 8 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$25.70$21.88 to $33.88
FacilityA hospital or hospital-owned outpatient department$39.81$28.18 to $58.88

How much rates vary

Facilitymedian $40 · 10th to 90th $22 to $83Professionalmedian $26 · 10th to 90th $20 to $49
$20$100$500$2K$10Kfacility $40professional $26

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
$23.44
Median
$45.71
Typical High
$93.33
Aetna
Setting
Facility
Modifier
CO · OT assistant
Typical Low
$72.44
Median
$72.44
Typical High
$72.44
Aetna
Setting
Facility
Modifier
CQ · PT assistant
Typical Low
$5.50
Median
$23.99
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$19.95
Median
$25.70
Typical High
$47.86
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$18.20
Median
$23.99
Typical High
$33.88
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$27.54
Median
$35.48
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$53.70
Median
$72.44
Typical High
$208.93
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
$30.20
Typical High
$61.66
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$28.84
Median
$34.67
Typical High
$42.66
Medcost
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$41.69
Typical High
$41.69
Medcost
Setting
Facility
Modifier
Global
Typical Low
$21.38
Median
$30.90
Typical High
$53.70
Medcost
Setting
Professional
Modifier
Global
Typical Low
$35.48
Median
$35.48
Typical High
$35.48
Sentara
Setting
Facility
Modifier
Global
Typical Low
$22.39
Median
$37.15
Typical High
$147.91
Sentara
Setting
Professional
Modifier
Global
Typical Low
$22.39
Median
$37.15
Typical High
$147.91
United
Setting
Facility
Modifier
Global
Typical Low
$32.36
Median
$35.48
Typical High
$36.31
United
Setting
Professional
Modifier
Global
Typical Low
$23.99
Median
$33.11
Typical High
$43.65

Where Virginia 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.

Virginia· 32nd of 51

$27.54

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.