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Observation Follow-Up Visit, High Complexity

Massachusetts 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 $234 · 10th–90th $200$1,0000%20%40%10th90th$234Professionalmedian $479 · 10th–90th $479$4790%50%$479$100.0$200.0$500.0$1.0K

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
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$199.53
Typical High
$1,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$93.33