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Georgia rates for HCPCS 99223

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 high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.

Facilitymedian $178 · 10th–90th $145–$2400%20%40%10th90th$178Professionalmedian $178 · 10th–90th $129–$4070%20%10th90th$178$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
$144.54 / $169.82 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $177.83 / $416.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $302.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $213.80 / $354.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $245.47 / $338.84
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $208.93 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $257.04 / $389.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $223.87 / $416.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $275.42 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $229.09 / $467.74