97165 · North Carolina · every payer
What every payer pays for 97165 in North Carolina
Across 11 commercial payers in North Carolina, the middle payer's median for 97165 (occupational therapy evaluation, level 1 of 3) is $84.44 per session. North Carolina Medicaid's fee-for-service rate, $64.14 per session, is 24% below that commercial median.
- Commercial median
- $84.44per session
- North Carolina Medicaid
- $64.14
- Medicare
- $97.15
On this page
Payer mix
97165 in North Carolina, by payer type
Medicare's physician fee schedule pays $97.15 in North Carolina.
By payer
Each payer's 97165 rate in North Carolina
FAQ
Frequently asked questions
What do commercial payers pay for 97165 in North Carolina?
The median of 11 payers' medians is $84.44 per session, from 335 published rates in the October 2026 files.
How does North Carolina Medicaid compare with commercial insurance for 97165?
North Carolina Medicaid pays $64.14 per session, 24% below the commercial median.
What does Medicare pay for 97165 in North Carolina?
$97.15 on the RVU26B physician fee schedule (non-facility).
What does UnitedHealthcare pay for 97165 in North Carolina?
UnitedHealthcare's median is $79.09 per session, from 154 rates and 512 providers.
What does Aetna pay for 97165 in North Carolina?
Aetna's median is $84.38 per session, from 70 rates and 1053 providers.