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Ohio 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 $74 · 10th–90th $52–$6170%20%10th90th$74Professionalmedian $79 · 10th–90th $56–$1700%20%10th90th$79$1.0$5.0$20.0$100.0$500.0$2.0K

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
$50.12 / $67.61 / $123.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$426.58 / $616.60 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $79.43 / $169.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $75.86 / $104.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $74.13 / $107.15
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $141.25
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $93.33 / $114.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $102.33 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $85.11 / $123.03
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
$66.07 / $91.20 / $141.25
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $89.13 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $79.43 / $100.00
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $91.20 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $79.43 / $123.03