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Nationwide rates for HCPCS 99219

Initial observation care, per day, for the evaluation and management of a patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the problem(s) requiring admission to outpatient hospital "observation status" are of moderate severity. Typically, 50 minutes are spent at the bedside and on the patient's hospital floor or unit.

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.83 / $342.50 / $1,228.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.32 / $416.90 / $832.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.87 / $531.80 / $640.51

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