go back

New York 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 $91 · 10th–90th $54–$1860%20%40%10th90th$91Professionalmedian $81 · 10th–90th $54–$1950%20%10th90th$81$1.0$10.0$100.0$1.0K$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
$58.88 / $91.20 / $181.97
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $81.28 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $72.44 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $58.88 / $158.49
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $123.03 / $53,703.18
Cigna
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $102.33 / $245.47
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $79.43 / $177.83
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $79.43 / $131.83
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $87.10 / $144.54
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $93.33 / $194.98
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $102.33 / $158.49
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $79.43 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $77.62 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $100.00 / $158.49
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $64.57 / $190.55
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $83.18 / $199.53