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Indiana 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.

Facilitymedian $62 · 10th–90th $62$38,9050%20%40%90th$62Professionalmedian $79 · 10th–90th $63$1700%10%20%10th90th$79$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38,904.51 / $38,904.51 / $38,904.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $61.66
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $77.62 / $109.65