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Kentucky 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 $112 · 10th–90th $85–$1950%20%10th90th$112Professionalmedian $135 · 10th–90th $91–$2340%10%10th90th$135$1.0$5.0$20.0$100.0$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $151.36
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $134.90 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $165.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $186.21
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $199.53
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $151.36 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $208.93 / $602.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $229.09