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Maine 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 $138 · 10th–90th $66–$2450%20%10th90th$138Professionalmedian $76 · 10th–90th $55–$1550%20%10th90th$76$1.0$5.0$20.0$100.0$500.0$2.0K$10.0K

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
$66.07 / $138.04 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $75.86 / $151.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $102.33 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $117.49 / $223.87
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $158.49
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $104.71 / $181.97
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $83.18 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $102.33 / $154.88