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Virginia 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.

Professionalmedian $105 · 10th–90th $76$1950%10%10th90th$105$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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $389.05
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $194.98