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Observation Follow-Up Visit, High Complexity

Washington 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 $162 · 10th–90th $71$2450%10%10th90th$162Professionalmedian $170 · 10th–90th $79$2450%10%10th90th$170$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
Cigna
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$229.09
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$70.79
Median
$162.18
Typical High
$257.04
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$173.78
Typical High
$245.47
Molina
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$70.79
Typical High
$70.79
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$194.98
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$74.13
Typical High
$100.00
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$169.82