Occupational therapy evaluation is a therapy or rehabilitation service. Prices are from 2310 US hospitals across 52 states, from their machine-readable files.
Price comparison (median)
Typical cash price here is $240 — about 2.4× the Medicare rate ($101). On the higher side. A fair cash price is usually within ~2× Medicare ($201).
💡 Asking for the cash price instead of the $399 list price could save about $158 (40%).
Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.
Lowest cash prices
| Hospital | Location | Cash | Insurer | CMS rating | ER wait | Readmit |
|---|---|---|---|---|---|---|
| Bsa Hospital | Amarillo, TX | $38 | $262 | ★ 2/5 | 217 min | 14.8% |
| Banner-University Medical Center Tucson Campus | Tucson, AZ | $39 | $127 | ★ 3/5 | 306 min | 14.6% |
| University of Ks Hlth System Great Bend Campus | Great Bend, KS | $40 | $98 | ★ 4/5 | 107 min | 14.5% |
| Hamilton Medical Center | Dalton, GA | $42 | — | ★ 3/5 | 187 min | 15.3% |
| East Jefferson General Hospital | Metairie, LA | $44 | $72 | ★ 2/5 | 162 min | 15.3% |
| Ochsner LSU Health Monroe | Monroe, LA | $44 | $95 | ★ 3/5 | 155 min | 15.2% |
| Baptist Health Medical Center-Arkadelphia | Arkadelphia, AR | $49 | $166 | — | 95 min | 15.2% |
| Baptist Health Medical Center Heber Springs | Heber Springs, AR | $49 | $151 | ★ 3/5 | 115 min | 15.2% |
| Banner-University Medical Center South Campus | Tucson, AZ | $49 | $130 | ★ 4/5 | 275 min | 14.5% |
| Luminis Health J Kent McNew Family Medical Center | Annapolis, MD | $49 | — | — | — | — |
| Slidell Memorial Hospital | Slidell, LA | $49 | $95 | ★ 2/5 | 203 min | 16.0% |
| West Jefferson Medical Center | Marrero, LA | $49 | $84 | ★ 3/5 | 154 min | 15.0% |
| Elbert Memorial Hospital | Elberton, GA | $50 | $74 | — | 120 min | 15.0% |
| Clarke County Hospital | Osceola, IA | $50 | $68 | ★ 5/5 | 104 min | 14.8% |
| Virtua Our Lady of Lourdes Hospital | Camden, NJ | $50 | — | ★ 2/5 | 161 min | 15.4% |
| Virtua Willingboro Hospital | Willingboro, NJ | $50 | — | ★ 3/5 | 181 min | 14.8% |
| Tanner Medical Center-East Alabama | Wedowee, AL | $50 | $65 | — | 94 min | 14.6% |
| King's Daughters Medical Center-Brookhaven | Brookhaven, MS | $51 | $126 | ★ 3/5 | 136 min | 15.3% |
| Eisenhower Medical Center | Rancho Mirage, CA | $52 | $106 | ★ 4/5 | 259 min | 14.8% |
| Aurelia Osborn Fox Memorial Hospital | Oneonta, NY | $53 | $104 | ★ 3/5 | 123 min | 15.2% |
| Parkwest Medical Center | Knoxville, TN | $55 | $183 | ★ 3/5 | 259 min | 14.9% |
| University Medical Center of El Paso | El Paso, TX | $55 | $116 | ★ 3/5 | 242 min | 15.4% |
| Cumberland Medical Center | Crossville, TN | $56 | $156 | ★ 4/5 | 201 min | 15.1% |
| Morristown Hamblen Hospital Association | Morristown, TN | $56 | $156 | ★ 2/5 | 199 min | 15.7% |
| Roane Medical Center | Harriman, TN | $56 | $156 | ★ 4/5 | 174 min | 15.5% |
CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated July 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.
What insurers pay for Occupational therapy evaluation
Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $240; Medicare pays $101.
| Insurer | Hospitals | Negotiated median |
|---|---|---|
| Medicaid | 297 |
$63 – $164 |
| Tricare / VA | 398 |
$90 – $294 |
| Independent Health | 44 |
$66 – $267 |
| Devoted Health | 210 |
$86 – $116 |
| Univera | 9 |
$84 – $112 |
| Medicare | 516 |
$91 – $234 |
| Amerigroup | 154 |
$59 – $533 |
| Humana | 959 |
$88 – $421 |
| Centene / Ambetter | 716 |
$63 – $224 |
| Molina Healthcare | 526 |
$60 – $218 |
| Highmark | 119 |
$85 – $317 |
| AmeriHealth | 242 |
$57 – $459 |
| Bright Health | 49 |
$92 – $243 |
| Priority Health | 51 |
$68 – $328 |
| Geisinger | 61 |
$87 – $467 |
| UCare | 68 |
$83 – $295 |
| Anthem | 526 |
$63 – $420 |
| Oscar Health | 213 |
$95 – $256 |
| Security Health Plan | 59 |
$96 – $337 |
| UPMC Health Plan | 78 |
$97 – $404 |
| MVP Health Care | 79 |
$92 – $369 |
| UnitedHealthcare | 1461 |
$90 – $456 |
| Aetna | 1344 |
$89 – $447 |
| SelectHealth | 45 |
$96 – $373 |
| HealthPartners | 256 |
$91 – $350 |
| Sanford Health Plan | 64 |
$99 – $336 |
| Blue Cross Blue Shield | 1231 |
$94 – $453 |
| Medica | 245 |
$104 – $368 |
| AvMed | 60 |
$98 – $498 |
| Cigna | 1119 |
$98 – $538 |
| EmblemHealth | 56 |
$112 – $356 |
| Health Net | 270 |
$104 – $649 |
| Kaiser Permanente | 156 |
$103 – $794 |
| Coventry | 144 |
$95 – $487 |
| Healthcare Highways | 38 |
$147 – $558 |
| Harvard Pilgrim | 49 |
$138 – $411 |
| Workers' Comp / No-Fault | 144 |
$109 – $672 |
| MultiPlan / PHCS network | 836 |
$166 – $674 |
Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.
Where it’s cheapest
| State | Median cash |
|---|---|
| Mississippi | $111 |
| Tennessee | $119 |
| Arizona | $119 |
| Oklahoma | $120 |
| Alabama | $123 |
| Arkansas | $131 |
Prices by city
Prices by state
Does Medicare cover Occupational therapy evaluation?
Yes — Medicare generally covers Occupational therapy evaluation. It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $101. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $20 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.
General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.
About these prices
Based on prices published by 2310 US hospitals across 52 states, the typical (median) cash price is $240, versus a chargemaster (list) price around $399, a median insurer-negotiated rate of $168, a Medicare rate of about $101. Most cash prices fall between $105 and $571 — a wide spread, which is exactly why comparing hospitals pays off.
How to save
- Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
- Compare several nearby hospitals; prices for the same service can differ severalfold.
- Request a written estimate and the billing code (CPT/DRG) before scheduling.
- Use the Medicare benchmark above to judge whether a quote is reasonable.
- If you are uninsured, ask about financial assistance or prompt-pay discounts.
Frequently asked questions
How much does Occupational therapy evaluation cost without insurance?
Does Medicare cover Occupational therapy evaluation?
What does Medicare pay for Occupational therapy evaluation?
Why do Occupational therapy evaluation prices vary between hospitals?
Is the cash price lower than using insurance?
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