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Kentucky 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 $151 · 10th–90th $112–$2240%20%10th90th$151Professionalmedian $195 · 10th–90th $129–$3160%10%10th90th$195$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
$112.20 / $151.36 / $165.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $194.98 / $316.23
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $181.97 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $162.18 / $269.15
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $213.80 / $263.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $199.53 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $295.12 / $812.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $120.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $194.98 / $331.13