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Observation Follow-Up Visit, High Complexity

New York 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.

Facilitymedian $145 · 10th–90th $65$5500%20%40%10th90th$145Professionalmedian $132 · 10th–90th $85$1450%20%40%10th90th$132$100.0$200.0$500.0$1.0K$2.0K

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
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$144.54
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$512.86
Typical High
$2,570.40
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$131.83