CPT 97166Occupational TherapyUntimed · per session

OT evaluation — moderate complexity

Occupational therapy session illustration

What CPT 97166 covers

CPT 97166 is the moderate-complexity OT evaluation: expanded history, 3–5 performance deficits, and moderate clinical decision-making.

The most common evaluation level for pediatric outpatient OT.

Using 97166 on superbills

Typical for sensory-motor referrals with several affected areas (fine motor + sensory + self-care).
Support the level: list the deficits and comorbidities your report addresses.

Documentation that supports it

Expanded occupational profile including relevant comorbidities
Standardized measures covering 3–5 deficit areas and a plan of care

Common ICD-10 pairings

Examples seen in pediatric practice — always code the diagnosis that fits the client.

F82F84.0F88R27.8

FAQ

Is 97166 paid at a different rate than 97165?

Medicare currently pays the three OT evaluation levels the same; commercial payers vary. Your private-practice fee schedule can still differ by complexity — show your actual fee on the superbill.

97165OT evaluation — low complexity 97167OT evaluation — high complexity 97168OT re-evaluation 97530Therapeutic activities

Educational reference only — not billing, coding, or legal advice. CPT® is a registered trademark of the American Medical Association. Verify current code definitions and payer policies before billing.