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Massachusetts 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 $186 · 10th–90th $132–$1,3180%10%20%10th90th$186Professionalmedian $141 · 10th–90th $100–$3020%20%10th90th$141$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$131.83 / $181.97 / $1,230.27
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$120.23 / $794.33 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $134.90 / $295.12
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $316.23 / $1,737.80
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $831.76
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $316.23 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $239.88 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $204.17 / $302.00
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $134.90 / $380.19
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $120.23 / $199.53
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $208.93 / $302.00
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $1,047.13 / $1,862.09
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $223.87 / $316.23
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $316.23 / $1,737.80
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $831.76
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $1,412.54 / $3,019.95
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $131.83 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $199.53 / $323.59