Occupational therapy evaluation Cost by Hospital

Occupational therapy evaluation is a therapy or rehabilitation service. Prices are from 2326 US hospitals across 52 states, from their machine-readable files.

$240median cash price · 2326 hospitals, 52 statestypically $105–$571 depending on the hospital
≈ 2.4× Medicare · On the higher sideFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$399
Cash / self-pay
$240
Insurer-negotiated
$168
Medicare pays
$101
$105$571
Median cash $240  ·  Medicare $101  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

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 $159 (40%).

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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
Bsa Hospital Amarillo, TX $38 $262 ★ 2/5 215 min —
Banner-University Medical Center Tucson Campus Tucson, AZ $39 $127 ★ 3/5 311 min —
University of Ks Hlth System Great Bend Campus Great Bend, KS $40 $98 ★ 4/5 107 min —
Hamilton Medical Center Dalton, GA $42 — ★ 3/5 181 min —
East Jefferson General Hospital Metairie, LA $44 $72 ★ 2/5 157 min —
Ochsner LSU Health Monroe Monroe, LA $44 $95 ★ 3/5 152 min —
Baptist Health Medical Center-Arkadelphia Arkadelphia, AR $49 $166 — 94 min —
Baptist Health Medical Center Heber Springs Heber Springs, AR $49 $151 ★ 3/5 110 min —
Banner-University Medical Center South Campus Tucson, AZ $49 $130 ★ 4/5 260 min —
Luminis Health J Kent McNew Family Medical Center Annapolis, MD $49 — — — —
Slidell Memorial Hospital Slidell, LA $49 $95 ★ 2/5 203 min —
West Jefferson Medical Center Marrero, LA $49 $84 ★ 3/5 147 min —
Elbert Memorial Hospital Elberton, GA $50 $74 — 118 min —
Clarke County Hospital Osceola, IA $50 $68 ★ 5/5 104 min —
Virtua Our Lady of Lourdes Hospital Camden, NJ $50 — ★ 2/5 168 min —
Virtua Willingboro Hospital Willingboro, NJ $50 — ★ 3/5 178 min —
Tanner Medical Center-East Alabama Wedowee, AL $50 $65 — 96 min —
King's Daughters Medical Center-Brookhaven Brookhaven, MS $51 $126 ★ 3/5 140 min —
Eisenhower Medical Center Rancho Mirage, CA $52 $106 ★ 4/5 259 min —
Aurelia Osborn Fox Memorial Hospital Oneonta, NY $53 $104 ★ 3/5 132 min —
Parkwest Medical Center Knoxville, TN $55 $183 ★ 3/5 259 min —
University Medical Center of El Paso El Paso, TX $55 $116 ★ 3/5 240 min —
Cumberland Medical Center Crossville, TN $56 $156 ★ 4/5 204 min —
Morristown Hamblen Hospital Association Morristown, TN $56 $156 ★ 2/5 198 min —
Roane Medical Center Harriman, TN $56 $156 ★ 4/5 174 min —

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 October 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.

InsurerHospitalsNegotiated median
Medicaid 301
$90
$63 – $168
Tricare / VA 402
$94
$90 – $292
Independent Health 44
$96
$66 – $267
Devoted Health 212
$98
$86 – $129
Univera 9
$99
$84 – $112
Medicare 522
$100
$91 – $234
Amerigroup 155
$100
$60 – $533
Humana 971
$104
$88 – $421
Molina Healthcare 532
$104
$60 – $226
Centene / Ambetter 740
$104
$63 – $226
Highmark 124
$105
$85 – $317
AmeriHealth 244
$112
$57 – $456
Bright Health 49
$125
$92 – $243
Priority Health 50
$126
$68 – $328
Geisinger 61
$135
$87 – $467
UCare 69
$149
$83 – $295
Oscar Health 228
$157
$96 – $264
UPMC Health Plan 79
$160
$97 – $404
Anthem 541
$162
$63 – $422
Security Health Plan 59
$163
$96 – $337
UnitedHealthcare 1489
$171
$90 – $453
MVP Health Care 81
$173
$92 – $369
Aetna 1368
$175
$89 – $447
SelectHealth 45
$184
$96 – $373
HealthPartners 257
$199
$91 – $350
Sanford Health Plan 66
$204
$99 – $336
Blue Cross Blue Shield 1242
$206
$94 – $451
Medica 248
$214
$104 – $368
AvMed 62
$232
$104 – $493
Cigna 1141
$233
$98 – $538
EmblemHealth 69
$233
$112 – $340
Health Net 271
$250
$104 – $648
Kaiser Permanente 157
$265
$103 – $794
Coventry 148
$266
$95 – $487
Healthcare Highways 38
$288
$147 – $558
Harvard Pilgrim 49
$293
$138 – $412
Workers' Comp / No-Fault 145
$298
$109 – $672
MultiPlan / PHCS network 852
$355
$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

StateMedian cash
Tennessee$116
Arizona$119
Oklahoma$120
Alabama$123
Mississippi$125
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 2326 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?
The median cash (self-pay) price across 2326 US hospitals is $240. Most hospitals fall between $105 and $571. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Occupational therapy evaluation?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $101). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Occupational therapy evaluation?
Medicare pays about $101. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Occupational therapy evaluation prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

Related Therapy & Rehab

See more Therapy & Rehab.