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Texas rates for HCPCS 99224

Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: Problem focused interval history; Problem focused examination; Medical decision making that is straightforward or of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Typically, 15 minutes are spent at the bedside and on the patient's hospital floor or unit.

Facilitymedian $89 · 10th–90th $89$890%50%100%$89Professionalmedian $56 · 10th–90th $32$1820%20%40%10th90th$56$50.0$100.0

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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $186.21
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $33.11 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.90 / $64.57