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Minnesota 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 $251 · 10th–90th $195–$5010%10%20%10th90th$251Professionalmedian $191 · 10th–90th $123–$2820%10%10th90th$191$100.0$200.0$500.0

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

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $251.19 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $204.17 / $288.40
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $239.88 / $467.74
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $269.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $87.10 / $112.20