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Maine rates for HCPCS 99233

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 high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.

Facilitymedian $204 · 10th–90th $178–$3550%20%10th90th$204Professionalmedian $107 · 10th–90th $78–$2290%20%10th90th$107$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
$177.83 / $275.42 / $354.81
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $107.15 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $173.78 / $331.13
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $177.83 / $239.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $275.42
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $91.20 / $138.04
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $107.15 / $181.97
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $151.36 / $234.42