Occupational therapy (self-care training)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 97535 (CPT)
- CPT Billing Code: 97535
- Insurance Median: $74
- Cash Discount Price: $100
- vs. Medicare Baseline: 2.28x 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 $32.4 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| United | $19 - $115 | 59% |
| Aetna | $19 - $30 | 59% |
| Medicaid / KanCare | $19 - $81 | 59% |
| Healthy Blue Kansas | $19 - $30 | 59% |
| Missouri Healthnet | $26 - $27 | 80% |
| Home State Health Plan | $28 | 86% |
| United Community Of Missouri | $28 | 86% |
| Healthy Blue Missouri | $28 | 86% |
| Humana | $30 | 93% |
| Blue Cross Blue Shield | $30 - $61 | 93% |
| Ilumed Aco Reach | $30 | 93% |
| Velocity | $36 - $76 | 111% |
| Prime Health Services | $39 - $87 | 120% |
| Americas Choice Provider Network | $69 - $71 | 213% |
| Quiktrip Corporation | $74 - $76 | 228% |
| Provider Network Of America | $74 - $76 | 228% |
| Usa Managed Care Organization | $74 - $76 | 228% |
| Multiplan-Phcs | $78 - $81 | 241% |
| Medincrease | $88 - $92 | 272% |
| Cigna | $104 | 321% |
| Providrs Care | $115 | 355% |
Consumer Guidance & Cost Commentary
For the Occupational therapy (self-care training) service at the Rehabilitation Hospital Of Overland Park, the cash price is $100.00, which is significantly higher than the state average of $42.00. While commercial insurance plans like United and Aetna negotiate rates ranging from $19 to $115, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that insurance negotiated rates include administrative costs and contract premiums that can inflate the baseline price by 20% to 40%, so the lowest possible cost for a patient is frequently the cash rate.
Before scheduling, patients should verify their specific plan's allowed amount and check for "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment. Although the facility is a Part A provider in Overland Park, KS, and the Medicare benchmark for this code is $32.40, commercial rates vary widely across 21 different payers. To avoid unexpected costs, consumers should request a full itemized bill to review CPT codes and ensure no services were bundled incorrectly, as over 80% of hospital bills contain errors. Always confirm with the hospital whether your specific plan qualifies for the lowest negotiated rate before assuming that in-network coverage will result in the cheapest total cost.