Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Connecticut Pricing in Context
In Connecticut, CPT code 97168 (Re-Evaluation For Occupational Therapy, Typically 30 Minutes) carries an average Medicare payment of $56.75 — 5% above the national benchmark of $54.27. 24 providers across the state submitted claims for this procedure in 2023, performing 105 total services. Individual payments in CT ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Connecticut is $180.39, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Connecticut sits above the national Medicare average, commercial rates in the state may also run higher than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Medicine procedures, the estimated commercial insurance price in Connecticut lands near $193.28, with self-pay cash prices typically around $106.45. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Re-Evaluation For Occupational Therapy, Typically 30 Minutes cost in Connecticut?
The average Medicare payment for Re-Evaluation For Occupational Therapy, Typically 30 Minutes in Connecticut is $56.75, which is 5% above the national average of $54.27. Providers in CT typically bill $180.39 for this procedure.
What does Re-Evaluation For Occupational Therapy, Typically 30 Minutes cost with insurance in Connecticut?
With commercial insurance in Connecticut, Re-Evaluation For Occupational Therapy, Typically 30 Minutes costs an estimated $193.28. Without insurance, the estimated cash price is $106.45. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Re-Evaluation For Occupational Therapy, Typically 30 Minutes in Connecticut?
24 providers in Connecticut billed Medicare for Re-Evaluation For Occupational Therapy, Typically 30 Minutes in 2023, performing 105 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Re-Evaluation For Occupational Therapy, Typically 30 Minutes cheaper in Connecticut than the national average?
No — Re-Evaluation For Occupational Therapy, Typically 30 Minutes costs 5% above the national average in Connecticut. The state average Medicare payment is $56.75 compared to $54.27 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.