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Observation Follow-Up Visit, High Complexity

Maine 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.

Professionalmedian $102 · 10th–90th $98$4900%10%20%10th90th$102$100.0$200.0$500.0

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
Cigna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$489.78
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$97.72
Typical High
$102.33