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Montana 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 $295 · 10th–90th $170–$3980%10%10th90th$295Professionalmedian $251 · 10th–90th $148–$6170%5%10th90th$251$20.0$50.0$100.0$200.0$500.0$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
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $245.47 / $588.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$154.88 / $281.84 / $660.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $295.12 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $281.84 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $239.88 / $436.52
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $323.59 / $389.05
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $323.59 / $389.05
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $234.42 / $416.87
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $331.13 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $275.42 / $371.54
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $91.20 / $269.15