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Observation Follow-Up Visit, Moderate Complexity

Illinois rates for HCPCS 99225

A follow-up visit by the doctor to a patient already being kept under observation in hospital. The doctor reviews how you have responded, checks results that have come back and adjusts the plan. This version covers a moderately involved review, where the picture is changing or several findings have to be weighed together.

Rates data updated July 2026.

How much rates vary

Facilitymedian $71 · 10th to 90th $50 to $871Professionalmedian $110 · 10th to 90th $79 to $324
$100$200$500facility $71professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$288.40
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$70.79
Typical High
$870.96
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$109.65