Occupational therapy (therapeutic activities)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $61
- Cash Discount Price: $108
- vs. Medicare Baseline: 1.74x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $35.07 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $27 - $33 | 77% |
| Medicaid / KanCare | $28 - $81 | 80% |
| Healthy Blue Kansas | $28 - $33 | 80% |
| United | $28 - $115 | 80% |
| Missouri Healthnet | $29 | 83% |
| United Community Of Missouri | $32 | 91% |
| Healthy Blue Missouri | $32 | 91% |
| Home State Health Plan | $32 | 91% |
| Humana | $33 | 94% |
| Blue Cross Blue Shield | $33 - $65 | 94% |
| Ilumed Aco Reach | $33 | 94% |
| Velocity | $39 - $81 | 111% |
| Prime Health Services | $42 - $92 | 120% |
| Americas Choice Provider Network | $75 | 214% |
| Usa Managed Care Organization | $81 | 231% |
| Provider Network Of America | $81 | 231% |
| Quiktrip Corporation | $81 | 231% |
| Multiplan-Phcs | $86 | 245% |
| Medincrease | $97 | 277% |
| Cigna | $104 | 297% |
| Providrs Care | $115 | 328% |
Consumer Guidance & Cost Commentary
For the CPT code 97530, representing occupational therapy therapeutic activities, the Rehabilitation Hospital Of Overland Park lists a cash median price of $108.00. This cash rate is significantly higher than the Medicare benchmark of $35.07, which serves as the federal baseline for this service. While the facility's median negotiated rate across payers is $61.00, this amount remains above the Medicare amount of $35.07, reflecting the standard administrative markup inherent in commercial contracts. Patients should note that while cash payment might appear expensive compared to the negotiated rate, it can sometimes be the most cost-effective option for those with high-deductible plans who have not yet met their coverage threshold, as the insurance allowed amount often exceeds the cash price.
To minimize out-of-pocket costs, patients are encouraged to verify their specific plan's negotiated rate before scheduling, as these amounts vary by carrier and can differ substantially from the facility's general average. It is also important to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims. Finally, if you receive a bill, always request a detailed, itemized statement rather than a summary invoice to ensure no errors exist, and remember that under the No Surprises Act, you are protected from balance billing for out-of-network services provided at this in-network facility.