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Minnesota rates for HCPCS 99226

Subsequent observation care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant complication or a significant new problem. Typically, 35 minutes are spent at the bedside and on the patient's hospital floor or unit.

Facilitymedian $363 · 10th–90th $275–$7080%10%20%10th90th$363Professionalmedian $269 · 10th–90th $178–$3980%10%20%10th90th$269$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. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $288.40 / $407.38
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $346.74 / $676.08
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $239.88 / $389.05
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $169.82