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Ohio 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 $3,020 · 10th–90th $3,020$3,0200%50%100%$3,020Professionalmedian $115 · 10th–90th $74$1580%10%10th90th$115$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
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,019.95 / $3,019.95
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $147.91 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $100.00 / $151.36