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Iowa rates for HCPCS 99220

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 high 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 high severity. Typically, 70 minutes are spent at the bedside and on the patient's hospital floor or unit.

Facilitymedian $219 · 10th–90th $219–$6030%20%40%90th$219Professionalmedian $372 · 10th–90th $200–$8510%20%10th90th$372$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $602.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $851.14 / $851.14
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $371.54 / $371.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $346.74 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $89.13 / $281.84