go back

Observation Follow-Up Visit, High Complexity

Pennsylvania 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 $102 · 10th–90th $72$2000%20%10th90th$102$100.0$200.0

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
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$72.44
Median
$72.44
Typical High
$123.03
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$181.97
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$93.33
Typical High
$165.96