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Kentucky 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.

Facilitymedian $38,905 · 10th–90th $38,905–$38,9050%50%100%$38,905Professionalmedian $89 · 10th–90th $68–$48,9780%20%10th90th$89$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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38,904.51 / $38,904.51 / $38,904.51
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46,773.51 / $48,977.88 / $51,286.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $77.62 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $95.50 / $158.49