go back

New Jersey 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 $158 · 10th–90th $117–$2690%20%10th90th$158Professionalmedian $195 · 10th–90th $123–$4570%10%10th90th$195$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
$117.49 / $158.49 / $269.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $190.55 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $316.23
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $213.80 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $263.03 / $524.81
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $154.88 / $257.04
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $138.04 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $199.53 / $389.05