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Kentucky 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
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38,904.51 / $38,904.51 / $38,904.51
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46,773.51 / $48,977.88 / $51,286.14
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $51.29 / $57.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $66.07 / $112.20