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Observation Follow-Up Visit, Moderate Complexity

Pennsylvania 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?

$48.98

Typical physician fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $48.98 for this service. Most negotiated rates run $48.98 to $58.88.

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 $49 · 10th to 90th $49 to $59Professionalmedian $49 · 10th to 90th $49 to $87
$50$100facility $49professional $49

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
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$58.88
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$48.98
Typical High
$83.18
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$57.54
Typical High
$57.54
United
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$50.12
Typical High
$50.12
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$102.33

Where Pennsylvania 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.

Pennsylvania· 48th of 49

$48.98

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.