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Observation Follow-Up Visit, High Complexity

Texas 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.

Facilitymedian $234 · 10th–90th $234$2340%50%100%$234Professionalmedian $145 · 10th–90th $83$4790%20%40%10th90th$145$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
Cigna
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$407.38
Typical High
$489.78
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$478.63
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$77.62
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$100.00
Typical High
$144.54