What every payer pays for 97165 in Massachusetts
8 commercial payers publish Massachusetts rates for 97165 (occupational therapy evaluation, level 1 of 3), and the median of their medians is $84.50 per session. Massachusetts Medicaid's fee-for-service rate, $76.54 per session, is 9.4% below that commercial median.
- Commercial median
- $84.50per session
- Massachusetts Medicaid
- $76.54
- Medicare
- $103.88+
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97165 in Massachusetts, by payer type
Medicare's physician fee schedule pays $103.88–$112.07 in Massachusetts across 2 localities.
Each payer's 97165 rate in Massachusetts
Frequently asked questions
What do commercial payers pay for 97165 in Massachusetts?
The median of 8 payers' medians is $84.50 per session, from 212 published rates in the October 2026 files.
How does Massachusetts Medicaid compare with commercial insurance for 97165?
Massachusetts Medicaid pays $76.54 per session, 9.4% below the commercial median.
What does Medicare pay for 97165 in Massachusetts?
$103.88 to $112.07 on the RVU26B physician fee schedule (non-facility).
What does UnitedHealthcare pay for 97165 in Massachusetts?
UnitedHealthcare's median is $103.97 per session, from 112 rates and 391 providers.
What does Kaiser Permanente pay for 97165 in Massachusetts?
Kaiser Permanente's median is $111.48 per session, from 38 rates and 47 providers.