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Tennessee rates for HCPCS 99221

Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Facilitymedian $129 · 10th–90th $76–$6760%10%10th90th$129Professionalmedian $115 · 10th–90th $66–$2510%5%10th90th$115$20.0$100.0$500.0$2.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $831.76
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $114.82 / $251.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $89.13 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $109.65 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $128.82 / $186.21
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $616.60
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $104.71 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $58.88 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $107.15 / $190.55