What every payer pays for 97165 in New Jersey
7 commercial payers publish New Jersey rates for 97165 (occupational therapy evaluation, level 1 of 3), and the median of their medians is $84.50 per session. New Jersey Medicaid's fee-for-service rate, $43.24 per session, is 49% below that commercial median.
- Commercial median
- $84.50per session
- New Jersey Medicaid
- $43.24
- Medicare
- $107.11+
On this page
97165 in New Jersey, by payer type
Medicare's physician fee schedule pays $107.11–$111.60 in New Jersey across 2 localities.
Each payer's 97165 rate in New Jersey
Frequently asked questions
What do commercial payers pay for 97165 in New Jersey?
The median of 7 payers' medians is $84.50 per session, from 538 published rates in the October 2026 files.
How does New Jersey Medicaid compare with commercial insurance for 97165?
New Jersey Medicaid pays $43.24 per session, 49% below the commercial median.
What does Medicare pay for 97165 in New Jersey?
$107.11 to $111.60 on the RVU26B physician fee schedule (non-facility).
What does Horizon BCBS NJ pay for 97165 in New Jersey?
Horizon BCBS NJ's median is $81.19 per session, from 171 rates and 2323 providers.
What does UnitedHealthcare pay for 97165 in New Jersey?
UnitedHealthcare's median is $72.75 per session, from 168 rates and 635 providers.