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Observation Follow-Up Visit, High Complexity

Montana 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

Professionalmedian $162 · 10th to 90th $79 to $200
$100$200professional $162

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
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$162.18
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43