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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.

Rates data updated July 2026.

How much does Observation Follow-Up Visit, High Complexity cost?

$479

Typical physician fee. In Texas, July 2026.

Insurers have agreed to pay about $479 for this service. Most negotiated rates run $234 to $479.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $234 · 10th to 90th $234 to $234Professionalmedian $479 · 10th to 90th $195 to $479
$100$200$500$1Kfacility $234professional $479

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

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
Facility
Modifier
Global
Typical Low
$125.89
Median
$134.90
Typical High
$1,258.93
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$87.10
Typical High
$112.20

Where Texas sits

The same service costs 15.8 times more in Texas than in Idaho. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Texas· 1st of 49

$479

TX $479ID $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.