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Pennsylvania 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 $62 · 10th–90th $54–$1100%50%10th90th$62Professionalmedian $81 · 10th–90th $55–$1780%20%10th90th$81$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$53.70 / $58.88 / $87.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $83.18 / $138.04
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $74.13 / $83.18
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $104.71 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $87.10 / $134.90
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $97.72 / $138.04
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $61.66 / $74.13
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $91.20 / $138.04
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $75.86
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $81.28 / $117.49
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $77.62 / $85.11
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $57.54 / $83.18
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $81.28 / $144.54
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $81.28 / $89.13
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $154.88
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $75.86 / $190.55
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.77 / $51.29 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $81.28 / $141.25