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Minnesota 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.

Facilitymedian $468 · 10th–90th $363–$9330%10%20%10th90th$468Professionalmedian $347 · 10th–90th $229–$5130%10%20%10th90th$347$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
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $467.74 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $380.19 / $537.03
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $446.68 / $870.96
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $316.23 / $501.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $630.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $162.18 / $208.93