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Wisconsin 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
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $208.93 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $194.98 / $269.15
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $70.79
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $162.18 / $162.18
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $338.84 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $63.10 / $120.23