97166 Ot evaluation mod complex 45 minutes
Also known as: OT eval moderate, Standard OT eval, Moderate OT eval
Occupational therapy evaluation of moderate complexity requiring 45 minutes. Comprehensive assessment of functional abilities and occupational performance.
In Plain Language
Occupational therapy initial evaluation - moderate case
Clinical Context
Used for patients with moderate functional impairment or multiple performance issues. Comprehensive baseline evaluation.
RVU Breakdown
| Work RVU | 1.54 |
| Total RVU | 1.54 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
Medicine section codes cover a wide range of non-surgical services. Documentation should include the clinical indication, procedure details, interpretation (if applicable), and any patient-specific findings.
How This Code Compares
With a work RVU of 1.54, this code ranks in the 71st percentile among Medicine codes — 2.0x the median (0.78). The highest wRVU in this category is 23.92.
Specialties
Frequently Asked Questions
What is CPT code 97166?
CPT 97166 (Ot evaluation mod complex 45 minutes) is a Medicine code. Occupational therapy evaluation of moderate complexity requiring 45 minutes. Comprehensive assessment of functional abilities and occupational performance.
Who uses CPT code 97166?
CPT 97166 is used by Occupational Therapy, Rehabilitation. Used for patients with moderate functional impairment or multiple performance issues. Comprehensive baseline evaluation.
When is CPT 97166 used?
Used for patients with moderate functional impairment or multiple performance issues. Comprehensive baseline evaluation.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against MGMA data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.