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Nationwide rates for HCPCS 99222

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 moderate level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.

Facilitymedian $158 · 10th–90th $105–$7590%10%20%10th90th$158Professionalmedian $141 · 10th–90th $98–$3240%20%10th90th$141$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$97.72 / $138.04 / $457.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$218.78 / $794.33 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $169.82 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $154.88 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $407.38 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $181.97 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $158.49 / $323.59

See more rates by state

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