97165 · Illinois · every payer
What every payer pays for 97165 in Illinois
Across 11 commercial payers in Illinois, the middle payer's median for 97165 (occupational therapy evaluation, level 1 of 3) is $93.77 per session. Illinois Medicaid's fee-for-service rate, $18.49 per session, is 80% below that commercial median.
- Commercial median
- $93.77per session
- Illinois Medicaid
- $18.49
- Medicare
- $96.48+
On this page
Payer mix
97165 in Illinois, by payer type
Medicare's physician fee schedule pays $96.48–$102.47 in Illinois across 4 localities.
By payer
Each payer's 97165 rate in Illinois
FAQ
Frequently asked questions
What do commercial payers pay for 97165 in Illinois?
The median of 11 payers' medians is $93.77 per session, from 375 published rates in the October 2026 files.
How does Illinois Medicaid compare with commercial insurance for 97165?
Illinois Medicaid pays $18.49 per session, 80% below the commercial median.
What does Medicare pay for 97165 in Illinois?
$96.48 to $102.47 on the RVU26B physician fee schedule (non-facility).
What does UnitedHealthcare pay for 97165 in Illinois?
UnitedHealthcare's median is $82.13 per session, from 188 rates and 695 providers.
What does BCBS Illinois pay for 97165 in Illinois?
BCBS Illinois's median is $101.57 per session, from 52 rates and 8355 providers.