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Tennessee 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 $204 · 10th–90th $151–$3890%20%10th90th$204Professionalmedian $195 · 10th–90th $135–$4790%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
$151.36 / $204.17 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $194.98 / $478.63
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $194.98 / $331.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $371.54
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,202.26 / $1,202.26
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $208.93 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $123.03 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $213.80 / $389.05