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Nationwide rates for HCPCS 99226

Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high 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 unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $363.08 / $851.14	Facility	$257.04	$363.08	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $239.88 / $407.38	Professional	$177.83	$239.88	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $100.00 / $100.00	Facility	$79.43	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $169.82	Professional	$75.86	$104.71	$169.82

Nationwide rates for HCPCS 99226

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