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Georgia rates for HCPCS 99205

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $229 · 10th–90th $145–$1,9950%10%20%10th90th$229Professionalmedian $224 · 10th–90th $145–$5010%10%20%10th90th$224$1.0$5.0$20.0$100.0$500.0$2.0K

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
$144.54 / $229.09 / $1,995.26
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$467.74 / $776.25 / $776.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $213.80 / $478.63
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $288.40 / $602.56
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $234.42 / $371.54
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$177.83 / $234.42 / $371.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $213.80 / $371.54
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $245.47 / $346.74
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $263.03 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $144.54 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $223.87 / $380.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $263.03 / $457.09
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $302.00 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $194.98 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $363.08
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $426.58