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New Jersey 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.

Professionalmedian $195 · 10th–90th $151$2750%20%10th90th$195$100.0$200.0$500.0

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
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $234.42