Occupational therapy evaluation Cost by Hospital

Occupational therapy evaluation is a therapy or rehabilitation service. Prices are from 2310 US hospitals across 52 states, from their machine-readable files.

$240median cash price · 2310 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 $158 (40%).

Estimate what you’ll pay
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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 ★ 2/5 217 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.

InsurerHospitalsNegotiated median
Medicaid 297
$90
$63 – $164
Tricare / VA 398
$93
$90 – $294
Independent Health 44
$96
$66 – $267
Devoted Health 210
$98
$86 – $116
Univera 9
$99
$84 – $112
Medicare 516
$100
$91 – $234
Amerigroup 154
$100
$59 – $533
Humana 959
$103
$88 – $421
Centene / Ambetter 716
$104
$63 – $224
Molina Healthcare 526
$104
$60 – $218
Highmark 119
$105
$85 – $317
AmeriHealth 242
$112
$57 – $459
Bright Health 49
$125
$92 – $243
Priority Health 51
$126
$68 – $328
Geisinger 61
$135
$87 – $467
UCare 68
$149
$83 – $295
Anthem 526
$153
$63 – $420
Oscar Health 213
$155
$95 – $256
Security Health Plan 59
$163
$96 – $337
UPMC Health Plan 78
$163
$97 – $404
MVP Health Care 79
$166
$92 – $369
UnitedHealthcare 1461
$170
$90 – $456
Aetna 1344
$175
$89 – $447
SelectHealth 45
$184
$96 – $373
HealthPartners 256
$199
$91 – $350
Sanford Health Plan 64
$203
$99 – $336
Blue Cross Blue Shield 1231
$206
$94 – $453
Medica 245
$214
$104 – $368
AvMed 60
$229
$98 – $498
Cigna 1119
$233
$98 – $538
EmblemHealth 56
$256
$112 – $356
Health Net 270
$257
$104 – $649
Kaiser Permanente 156
$266
$103 – $794
Coventry 144
$267
$95 – $487
Healthcare Highways 38
$288
$147 – $558
Harvard Pilgrim 49
$293
$138 – $411
Workers' Comp / No-Fault 144
$301
$109 – $672
MultiPlan / PHCS network 836
$352
$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
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?
The median cash (self-pay) price across 2310 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.