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Rhode Island 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 $204 · 10th–90th $170–$4790%20%10th90th$204Professionalmedian $214 · 10th–90th $135–$5250%5%10%10th90th$214$10.0$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
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $204.17 / $478.63
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $204.17 / $501.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $338.84 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $223.87 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $173.78 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $229.09 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $229.09 / $380.19
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $89.13 / $478.63