Occupational therapy (therapeutic activities)
Facility: Ascension Via Christi Rehabilitation Hospital Inc
Billing Code: 97530 (CPT)
- CPT Billing Code: 97530
- Insurance Median: $33
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.94x 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 |
|---|---|---|
| UnitedHealthcare | $33 - $91 | 94% |
| Medicare (plans) | $33 | 94% |
| Humana | $33 | 94% |
| Blue Cross Blue Shield | $33 | 94% |
| Va | $33 | 94% |
| Vc Hope | $33 | 94% |
| Smarthealth | $46 | 131% |
| Medicaid / KanCare | $55 | 157% |
| Aetna | $75 - $118 | 214% |
| Coventry City Of Wichita | $77 | 220% |
Consumer Guidance & Cost Commentary
For the Occupational therapy (therapeutic activities) service at Ascension Via Christi Rehabilitation Hospital Inc in Wichita, KS, the facility's negotiated rates with major payers like UnitedHealthcare, Medicare, and Humana range from $33 to $91. This pricing structure is significantly higher than the state average, which sits at $35.07 based on Medicare benchmarks. While commercial insurance contracts often include administrative overhead that inflates these rates, patients should be aware that cash-pay options may offer a lower total cost if their insurance negotiated rate exceeds the cash price. It is crucial to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can provide immediate fee reductions for those paying upfront.
Patients should also be cautious regarding balance billing and itemized billing practices. Although the No Surprises Act protects against unexpected out-of-network balance billing for emergency care and non-emergency services at in-network facilities, it is essential to request a full, itemized CPT-coded bill before agreeing to any payment plan. This detailed statement allows you to identify errors, double-billing, or unbundled codes that may have occurred, as over 80% of hospital bills contain inaccuracies. If you receive a summary bill or a verbal dispute resolution, you should insist on a written audit dispute sent to the billing supervisor to ensure all charges are accurate and transparent.