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Massachusetts rates for HCPCS 99232

Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Facilitymedian $89 · 10th–90th $69–$1780%20%10th90th$89Professionalmedian $81 · 10th–90th $58–$1860%20%10th90th$81$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $89.13 / $104.71
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $79.43 / $181.97
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $245.47 / $645.65
AllWays Health Partners
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $457.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $165.96 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $144.54 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $117.49 / $181.97
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $85.11 / $144.54
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $79.43 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $128.82 / $181.97
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,698.24 / $1,698.24
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $141.25 / $213.80
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $245.47 / $645.65
Mass General Brigham
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$43.65 / $43.65 / $43.65
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $107.15 / $457.09
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $75.86 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $107.15 / $194.98