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Observation Follow-Up Visit, High Complexity

Illinois rates for HCPCS 99226

A follow-up visit by the doctor to a patient under observation in hospital whose condition is unstable or has worsened. It covers a detailed reassessment, a full review of new findings, and complex decisions about changing treatment or moving to a full admission.

Rates data updated October 2026.

How much rates vary

Professionalmedian $151 · 10th to 90th $100 to $174
$100professional $151

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None
Typical Low
$100.00
Median
$100.00
Typical High
$151.36
United
Setting
Professional
Modifier
None
Typical Low
$173.78
Median
$173.78
Typical High
$173.78