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Observation Follow-Up Visit, High Complexity

Indiana 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.

Facilitymedian $93 · 10th–90th $93$38,9050%20%40%90th$93Professionalmedian $95 · 10th–90th $85$4070%20%10th90th$95$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
CareSource
Setting
Facility
Modifier
Global
Typical Low
$38,904.51
Median
$38,904.51
Typical High
$38,904.51
Cigna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$93.33
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$95.50
Typical High
$112.20