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Nationwide rates for HCPCS 99225

Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of moderate 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 responding inadequately to therapy or has developed a minor complication. Typically, 25 minutes are spent at the bedside and on the patient's hospital floor or unit.

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $251.19 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $169.82 / $288.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $70.79 / $70.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $72.44 / $117.49

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