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Pennsylvania 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.

Insurance Carrier
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $123.03
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $81.28 / $199.53
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $181.97 / $234.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $85.11 / $114.82