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Tennessee 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 $148–$1,1220%10%20%10th90th$204Professionalmedian $224 · 10th–90th $145–$5250%10%10th90th$224$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
$147.91 / $173.78 / $371.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$218.78 / $309.03 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $208.93 / $489.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $309.03 / $645.65
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $234.42 / $346.74
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$165.96 / $229.09 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $234.42 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $141.25 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $218.78 / $354.81
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $1,380.38 / $1,380.38
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $223.87 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $323.59
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $213.80 / $457.09