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Observation Follow-Up Visit, High Complexity

New Jersey 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 $148 · 10th–90th $117$2090%10%20%10th90th$148$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
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$147.91
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$87.10
Typical High
$181.97