go back

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
$26,249.74 / $38,499.62 / $47,999.52
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47,249.53 / $48,999.51 / $50,749.49
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.02 / $51.62 / $58.07