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Observation Follow-Up Visit, High Complexity

Virginia 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.

Facilitymedian $525 · 10th–90th $525$8910%20%40%90th$525Professionalmedian $117 · 10th–90th $87$3800%10%20%10th90th$117$100.0$200.0$500.0$1.0K

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
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$177.83
Typical High
$389.05
Medcost
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$102.33
Typical High
$151.36
United
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$524.81
Typical High
$891.25
United
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10