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Texas 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 $155 · 10th–90th $107–$5130%20%10th90th$155Professionalmedian $135 · 10th–90th $98–$3160%10%10th90th$135$10.0$20.0$50.0$100.0$200.0$500.0$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
$104.71 / $109.65 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $138.04 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $380.19 / $691.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $117.49 / $144.54
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $309.03
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $128.82 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $275.42
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $831.76 / $831.76
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $154.88 / $257.04
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $257.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $95.50
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $218.78 / $426.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $162.18 / $269.15
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $165.96 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $147.91 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $234.42
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $141.25