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Ohio 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 $132 · 10th–90th $87–$8130%20%10th90th$132Professionalmedian $138 · 10th–90th $93–$2820%20%10th90th$138$1.0$5.0$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
$85.11 / $112.20 / $407.38
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$616.60 / $776.25 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $134.90 / $288.40
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $169.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $147.91 / $213.80
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $147.91 / $181.97
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $151.36 / $190.55
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $295.12
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
$117.49 / $158.49 / $251.19
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $158.49 / $245.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $131.83 / $165.96
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $158.49 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $141.25 / $223.87