Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
OCCUPATIONAL THERAPY EVALUATION, LOW COMPLEXITY, REQUIRING THESE COMPONENTS: AN OCCUPATIONAL PROFILE AND MEDICAL AND THERAPY HISTORY, WHICH INCLUDES A BRIEF HISTORY INCLUDING REVIEW OF MEDICAL AND/OR THERAPY RECORDS RELATING TO THE PRESENTING PROBLEM; AN ASSESSMENT(S) THAT IDENTIFIES 1-3 PERFORMANCE DEFICITS (IE, RELATING TO PHYSICAL, COGNITIVE, OR PSYCHOSOCIAL SKILLS) THAT RESULT IN ACTIVITY LIMITATIONS AND/OR PARTICIPATION RESTRICTIONS; AND CLINICAL DECISION MAKING OF LOW COMPLEXITY, WHICH INCLUDES AN ANALYSIS OF THE OCCUPATIONAL PROFILE, ANALYSIS OF DATA FROM PROBLEM-FOCUSED ASSESSMENT(S), AND CONSIDERATION OF A LIMITED NUMBER OF TREATMENT OPTIONS. PATIENT PRESENTS WITH NO COMORBIDITIES THAT AFFECT OCCUPATIONAL PERFORMANCE. MODIFICATION OF TASKS OR ASSISTANCE (EG, PHYSICAL OR VERBAL) WITH ASSESSMENT(S) IS NOT NECESSARY TO ENABLE COMPLETION OF EVALUATION COMPONENT. TYPICALLY, 30 MINUTES ARE SPENT FACE-TO-FACE WITH THE PATIENT AND/OR FAMILY.
Philadelphia, PA
See all hospitals reporting CPT 97165 →Price type
Albert Einstein Medical Center’s median price of $113 is 27% below the median hospital's median price ($155), higher than 32% of the 2,514 hospitals reporting CPT 97165. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 7 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Humana medicare fee schedule · outpatient | $106.70 | $106.70 | $106.70 – $106.70 |
| 2 | UnitedHealthcare medicare fee schedule · outpatient | $108.83 | $108.83 | $108.83 – $108.83 |
| 3 | Cigna medicare fee schedule · outpatient | $110.97 | $110.97 | $110.97 – $110.97 |
| 4 | Highmark medicare fee schedule · outpatient | $112.04 | $112.04 | $112.04 – $112.04 |
| 5 | Aetna medicare fee schedule · outpatient | $113.10 | $113.10 | $113.10 – $113.10 |
| 6 | WellCare medicare fee schedule · outpatient | $117.37 | $117.37 | $117.37 – $117.37 |
| 7 | Aetna commercial fee schedule · outpatient | $120.72 | $120.72 | $120.72 – $120.72 |
Last updated: Dec 23, 2025
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