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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
$180.22 / $210.61 / $323.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.24 / $193.20 / $228.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.79 / $335.79 / $335.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$145.66 / $145.66 / $145.66
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.96 / $335.79 / $335.79