Low Complexity Occupational Therapy Evaluation

CPT Code 97165

A low complexity occupational therapy evaluation, lasting 20 minutes. This estimate is the cost per unit. You may receive multiple units during one visit. To calculate the total cost estimate, multiply the estimate by the number of units.

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Actual driving distances may vary
Provider NameSort by Provider Name Estimate of Procedure Cost Estimate of Procedure Cost
This is an estimate of the total charge for the health care service before any discounts provided to the uninsured.
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Number of Visits Number of Visits
When the number of visits varies, it is difficult to estimate the total cost of care. This indicates the number of visits you can expect, calculated using the median. To determine the total you might pay, multiply the Estimate of Procedure Cost and the Statewide Average for Number of Visits.
- Above Average: Expect to visit the provider more than the average number of visits.
- Near Average: Expect the visit the provider close to the average number of visits.
- Below Average: Expect to visit the provider less than the average number of visits.
Uninsured Discount Uninsured Discount
The minimum discount rate that the health care provider gives to the New Hampshire Insurance Department. The actual discount depends on your financial status and the health care provider’s charity care policy.
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What You Will Pay What You Will Pay
The estimated charge amount minus the uninsured discount (when available).
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Statewide Averages $510 1
St. Joseph Hospital
Nashua, NH
$227 Near Average 61% $88
Elliot Hospital
Manchester, NH
$288 Near Average 59% $118
Exeter Hospital
Exeter, NH
$393 Near Average 63% $146
$240 Near Average 37% $151
$478 Near Average 57% $205
$392 Near Average 40% $235
Monadnock Community Hospital
Peterborough, NH
$434 Near Average 38% $269
$510 Near Average 40% $306
$311 Near Average 0% $311
$368 Near Average 0% $368
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