CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Mississippi Methodist Rehab Ctr

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97535
Insurance Median: $66
Cash Discount Price: $33
vs. Medicare Baseline: 2.04x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Mississippi Methodist Rehab Ctr is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 2.04x the Medicare baseline. Located in 1350 E Woodrow Wilson Dr, Jackson, MS.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$32.4

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.4 (100%)

Cash / Self-Pay: $33 (102%)

Insurance Median: $66 (204%)

Cash: $33 (102% of Medicare)

Ins. Median: $66 (204% of 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 204% of the Medicare baseline (a markup of 104%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
American Hlth Adv Mcr - All Plans	$29	90%
Humana	$29	90%
Molina Marketplace - All Other Plans	$29	90%
Molina Mcr Adv	$29	90%
Shared Health Dsnp - All Plans	$29	90%
UnitedHealthcare	$29 - $119	90%
Va Ccn - All Plans	$29	90%
Wellcare Mcr Adv - All Plans	$29	90%
Cigna	$30 - $185	93%
First Choice - All Plans	$44	136%
Blue Cross Blue Shield	$65 - $81	201%
Magnolia Mcaid - All Plans	$67 - $108	207%
Molina Mcaid/Chip	$67 - $108	207%
Mpcn - All Plans	$86	265%
Ambetter / Centene	$156	481%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $33.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97535.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mississippi Methodist Rehab Ctr is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97535.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.