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Tennessee rates for HCPCS 99203

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $468 · 10th–90th $79–$5130%20%10th90th$468Professionalmedian $110 · 10th–90th $66–$2400%5%10%10th90th$110$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
$79.43 / $128.82 / $691.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $104.71 / $234.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$69.18 / $120.23 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $165.96
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $112.20 / $165.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $114.82 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $208.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $109.65 / $177.83
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $691.83 / $691.83
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $114.82 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $67.61 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $102.33 / $165.96
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $177.83