Occupational therapy evaluation, moderate complexity, 45 minutes at Metropolitan Methodist

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.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy r

SAN ANTONIO, TX

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How this price compares nationally

Metropolitan Methodist’s median price of $104 is 38% below the median hospital's median price ($167), higher than 19% of the 2,506 hospitals reporting CPT 97166. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 97166 at Metropolitan Methodist

Negotiated rates from the hospital’s own file: 10 payers, 44 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	First Health chip percent of total billed charges · outpatientfrom % of charges	$79	$79	$3	3%	—	$77 – $82
2	First Health chipperinate percent of total billed charges · outpatientfrom % of charges	$79	$79	$3	3%	—	$77 – $82
3	First Health mcdstar percent of total billed charges · outpatientfrom % of charges	$79	$79	$3	3%	—	$77 – $82
4	Blue Cross Blue Shield mgmcrhmo fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
5	Blue Cross Blue Shield mgmcrpos fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
6	Blue Cross Blue Shield mgmcrppo fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
7	Devoted dualeligible fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
8	Devoted mcrhmo fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
9	Devoted mcrpffs fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
10	Devoted mcrpos fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
11	Devoted mcrppo fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
12	Devoted mcrsnp fee schedule · outpatient	$92	$92	$6	6%	—	$86 – $98
13	Aetna mcr fee schedule · outpatient	$94	$94	$6	6%	—	$88 – $100
14	UnitedHealthcare mcr fee schedule · outpatient	$94	$94	$6	6%	—	$88 – $100
15	WellCare mcrhmo fee schedule · outpatient	$95	$95	$6	6%	—	$89 – $101
16	WellCare mcrpos fee schedule · outpatient	$95	$95	$6	6%	—	$89 – $101
17	WellCare mcrppo fee schedule · outpatient	$95	$95	$6	6%	—	$89 – $101
18	WellCare mcrsnp fee schedule · outpatient	$95	$95	$6	6%	—	$89 – $101
19	WellCare pffs fee schedule · outpatient	$95	$95	$6	6%	—	$89 – $101
20	Clover mcr fee schedule · outpatient	$97	$97	$6	6%	—	$91 – $103
21	Oscar broadnetworkhix percent of total billed charges · outpatientfrom % of charges	$132	$132	$4	3%	—	$128 – $137
22	Oscar epo percent of total billed charges · outpatientfrom % of charges	$132	$132	$4	3%	—	$128 – $137
23	Oscar pos percent of total billed charges · outpatientfrom % of charges	$132	$132	$4	3%	—	$128 – $137
24	Oscar ppo percent of total billed charges · outpatientfrom % of charges	$132	$132	$4	3%	—	$128 – $137
25	Molina mcr fee schedule · outpatient	$147	$147	$9	6%	—	$137 – $156

Page 1 of 2 · 44 rates

Last updated: May 1, 2026

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