go back

New York 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 $79 · 10th–90th $37–$4270%10%10th90th$79Professionalmedian $81 · 10th–90th $43–$1950%10%10th90th$81$0.1$0.5$2.0$10.0$50.0$200.0$1.0K

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
$37.15 / $74.13 / $316.23
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$112.20 / $281.84 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $79.43 / $186.21
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $93.33 / $213.80
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $69.18 / $89.13
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$57.54 / $70.79 / $83.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $363.08 / $398.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $61.66 / $114.82
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $69.18
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $102.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $85.11 / $162.18
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $54.95
Emblem Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$0.10 / $0.10 / $0.10
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $72.44 / $120.23
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $38.90 / $79.43
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $72.44 / $144.54
Fidelis
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $70.79 / $70.79
Fidelis
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$39.81 / $61.66 / $93.33
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $95.50 / $213.80
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $93.33 / $112.20
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $104.71 / $162.18
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $79.43 / $109.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $45.71 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $85.11 / $204.17
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $91.20 / $144.54
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$24.55 / $48.98 / $89.13
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $77.62 / $123.03