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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 October 2026.

How much rates vary

Professionalmedian $65 · 10th to 90th $65 to $107
$100professional $65

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

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None
Typical Low
$91.20
Median
$107.15
Typical High
$194.98
Molina
Setting
Professional
Modifier
None
Typical Low
$64.57
Median
$64.57
Typical High
$81.28