CMS Price Transparency Data

Occupational therapy (therapeutic activities)

Facility: Titus Regional Medical Center

Billing Code: 97530 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97530
Insurance Median: $54
Cash Discount Price: $61
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Occupational therapy (therapeutic activities) at Titus Regional Medical Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $35.07, this hospital’s rate is 1.54x the Medicare baseline. Located in 2001 N Jefferson, Mount Pleasant, TX.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$35.07

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $35.07 (100%)

Cash / Self-Pay: $61 (174%)

Insurance Median: $54 (154%)

Cash: $61 (174% of Medicare)

Ins. Median: $54 (154% of 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.

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
Aetna	$24 - $56	68%
Christus Health Plan	$25	71%
Humana	$25 - $71	71%
Tricare	$25	71%
Triwest	$25	71%
UnitedHealthcare	$25 - $101	71%
Texas Mutual	$26	74%
Curative	$27 - $61	77%
Blue Cross Blue Shield	$30 - $117	86%
Claritev	$39 - $81	111%
Healthcare Highways	$40 - $49	114%
Superior	$46 - $54	131%
Healthsmart	$71 - $83	202%
Cigna	$81 - $95	231%
Galaxy Health	$96 - $113	274%

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 $61.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97530.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Titus Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97530.
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.