go back

Pennsylvania 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 $95 · 10th–90th $95–$950%50%100%$95Professionalmedian $209 · 10th–90th $141–$3550%20%10th90th$209$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
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $245.47
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $323.59 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $257.04