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New Jersey 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 $107 · 10th–90th $79–$1820%20%10th90th$107Professionalmedian $138 · 10th–90th $85–$2950%10%10th90th$138$10.0$50.0$200.0$1.0K

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
$79.43 / $100.00 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $138.04 / $302.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $138.04 / $204.17
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $1,905.46 / $2,818.38
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $147.91 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $181.97 / $288.40
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $117.49 / $194.98
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $154.88 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $138.04 / $269.15