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Observation Follow-Up Visit, High Complexity

Michigan 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.

How much rates vary

Facilitymedian $263 · 10th to 90th $107 to $295Professionalmedian $117 · 10th to 90th $100 to $141
$100$200facility $263professional $117

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$263.03
Typical High
$295.12
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$117.49
Typical High
$144.54
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$87.10