CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: OHSU Hospital and Clinics

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $41
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at OHSU Hospital and Clinics is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.27x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $119 (367%)
Insurance Median: $41 (127%)
Cash: $119 (367% of Medicare)
Ins. Median: $41 (127% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Care Oregon $28 - $41 86%
Intercommunity Health Network $28 86%
Kaiser Foundation Hospitals $28 - $80 86%
Medicare (plans) $28 - $55 86%
Pacific Source $28 - $142 86%
Humana $34 - $37 105%
Trillium $34 105%
Community Health Plan Of Washington $35 - $48 108%
Moda $36 - $120 111%
Aetna $37 - $143 114%
Samaritan Health Plan $37 - $86 114%
UnitedHealthcare $37 - $59 114%
Health Net Health Plan Of Oregon, Inc. $40 - $142 123%
Providence Health Plan $41 - $156 127%
Blue Cross Blue Shield $113 349%
Tuality Health $119 367%
Coventry First Health $137 423%
First Choice $139 429%
Cigna $167 515%
Molina Exchange $183 565%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3181 Sw Sam Jackson Park Road, Portland, OR 97239
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals