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Observation Follow-Up Visit, Moderate Complexity

North Carolina 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 physician fee. In North Carolina, July 2026.

Insurers have agreed to pay about $339 for this service. Most negotiated rates run $97.72 to $339.

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.

How much rates vary

Facilitymedian $162 · 10th to 90th $162 to $162Professionalmedian $339 · 10th to 90th $79 to $339
$100$200facility $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
Medcost
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$97.72
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$162.18
Wellcare
Setting
Professional
Modifier
Global
Typical Low
$338.84
Median
$338.84
Typical High
$338.84

Where North Carolina 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.

North Carolina· 5th 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.