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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.

Facilitymedian $269 · 10th–90th $107$2950%20%10th90th$269Professionalmedian $115 · 10th–90th $98$1410%20%10th90th$115$100.0$200.0

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
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
$107.15
Typical High
$131.83