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Observation Follow-Up Visit, Moderate Complexity

Massachusetts 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 does Observation Follow-Up Visit, Moderate Complexity cost?

$339

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $339 for this service. The price depends on where it is billed: about $339 from a physician practice, and about $162 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$339$339 to $339
FacilityA hospital or hospital-owned outpatient department$162$162 to $200

How much rates vary

Facilitymedian $162 · 10th to 90th $162 to $1,000Professionalmedian $339 · 10th to 90th $91 to $339
$100$200$500$1Kfacility $162professional $339

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
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$1,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$107.15

Where Massachusetts sits

The same service costs 11.2 times more in Tennessee than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 2nd of 49

$339

TN $339SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.