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Massachusetts rates for HCPCS 99202

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.

Facilitymedian $74 · 10th–90th $34$1320%10%10th90th$74Professionalmedian $87 · 10th–90th $47$2040%5%10th90th$87$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $85.11 / $114.82
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $79.43 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$57.54 / $104.71 / $245.47
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $158.49 / $302.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $85.11 / $245.47
AllWays Health Partners
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$27.54 / $44.67 / $91.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $87.10 / $154.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $93.33 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$47.86 / $79.43 / $154.88
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21.38 / $38.02 / $69.18
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $67.61 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $93.33 / $186.21
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $234.42
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $114.82 / $218.78
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $158.49 / $302.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $85.11 / $245.47
Mass General Brigham
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$27.54 / $44.67 / $91.20
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $44.67 / $44.67
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $95.50 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $63.10 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $89.13 / $190.55
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $79.43 / $173.78