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Washington 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 $195 · 10th–90th $91–$3160%10%10th90th$195Professionalmedian $195 · 10th–90th $91–$3090%10%10th90th$195$100.0$200.0

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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $302.00
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $194.98 / $316.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $213.80 / $316.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $257.04 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $173.78 / $281.84