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Observation Follow-Up Visit, High Complexity

Kentucky 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 July 2026.

Facilitymedian $38,905 · 10th–90th $38,905$38,9050%50%100%$38,905Professionalmedian $87 · 10th–90th $65$48,9780%20%10th90th$87$100.0$500.0$2.0K$10.0K$50.0K

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
CareSource
Setting
Professional
Modifier
Global
Typical Low
$46,773.51
Median
$48,977.88
Typical High
$51,286.14
Molina
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$77.62
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$89.13