CMS Price Transparency Data

Occupational therapy (self-care training)

Facility: Medical City Fort Worth

Billing Code: 97535 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97535
  • Insurance Median: $34
  • Cash Discount Price: $146
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Occupational therapy (self-care training) at Medical City Fort Worth is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $32.4, this hospital’s rate is 1.05x the Medicare baseline. Located in 900 Eighth Avenue, Fort Worth, TX.
Cash / Self-Pay
$146

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $146 (451%)
Insurance Median: $34 (105%)
Cash: $146 (451% of Medicare)
Ins. Median: $34 (105% 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
Superior Health Plan $10 - $34 31%
Cigna $20 - $78 62%
Amerigroup $28 - $32 86%
Blue Cross Blue Shield $28 - $187 86%
Devoted Health $28 - $32 86%
Humana $28 - $243 86%
Mutual Of Omaha $28 - $32 86%
Triwest $28 - $32 86%
United $28 - $32 86%
Wellmed $28 - $32 86%
Aetna $29 - $179 90%
Care N Care $29 - $33 90%
Integranet $29 - $33 90%
Wellcare $29 - $33 90%
American Health Plan Of Texas, Inc. $30 - $34 93%
Oscar $30 93%
Procare Advantge $30 - $34 93%
Provider Partners Health Plan $30 - $34 93%
Texas Independent Health Plan $30 - $34 93%
Imperial Insurance Company $31 - $35 96%
Molina $31 - $35 96%
Triwest Health Alliance $32 99%
Unicare $32 - $146 99%
Universal Healthcare Group $34 - $39 105%
Verda Health Plan $37 - $42 114%
Bravo Health $43 - $48 133%
Healthcare Highways $49 151%
Superior $51 - $72 157%
Usa Managed Care $54 - $117 167%
Corvel Corporation $56 - $64 173%
City Of Mckinney $66 204%
Fidelis Securecare $66 204%
Emerging Therapy Solutions $73 - $105 225%
National Choicecare $73 225%
Molina Healthcare $74 - $84 228%
Pc Texas Partners $80 247%
Physicians Coop Of Tx $80 247%
Rockport Health Group $80 247%
Averde Health, Inc $85 262%
Coastal Comp Health Networks $102 315%
Mega Life $102 315%
Multiplan Phcs $102 315%
Healthsmart Preferred Care $104 321%
Lewisville Isd/Dls Consulting $110 340%
Tcu Athletics $117 361%
Usc Health Services $117 361%
Galaxy Health Network $124 383%
UnitedHealthcare $126 389%
Independent Medical Systems $146 451%
National Healthcare Solutions $146 451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 900 Eighth Avenue, Fort Worth, TX 76104
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals