Oregon · 97168

Re-Evaluation For Occupational Therapy, Typically 30 Minutes in Oregon

Oregon Medicare Avg
$49.89
8% below national avg
National Medicare Avg
$54.27
All states combined
Billed Charge (OR)
$158.48
What providers submit
Est. Commercial (OR)
$150.74
National avg: $151.14
Est. Cash / Self-Pay (OR)
$92.73
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

421
Services in OR
53
Providers
N/A
Min Payment
N/A
Max Payment

Oregon Pricing in Context

In Oregon, CPT code 97168 (Re-Evaluation For Occupational Therapy, Typically 30 Minutes) carries an average Medicare payment of $49.89 — 8% below the national benchmark of $54.27. 53 providers across the state submitted claims for this procedure in 2023, performing 421 total services. Individual payments in OR 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 Oregon is $158.48, 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 Oregon sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Medicine procedures, the estimated commercial insurance price in Oregon lands near $150.74, with self-pay cash prices typically around $92.73. 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 Oregon?

The average Medicare payment for Re-Evaluation For Occupational Therapy, Typically 30 Minutes in Oregon is $49.89, which is 8% below the national average of $54.27. Providers in OR typically bill $158.48 for this procedure.

What does Re-Evaluation For Occupational Therapy, Typically 30 Minutes cost with insurance in Oregon?

With commercial insurance in Oregon, Re-Evaluation For Occupational Therapy, Typically 30 Minutes costs an estimated $150.74. Without insurance, the estimated cash price is $92.73. 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 Oregon?

53 providers in Oregon billed Medicare for Re-Evaluation For Occupational Therapy, Typically 30 Minutes in 2023, performing 421 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 Oregon than the national average?

Yes — Re-Evaluation For Occupational Therapy, Typically 30 Minutes costs 8% below the national average in Oregon. The state average Medicare payment is $49.89 compared to $54.27 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial