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Massachusetts rates for HCPCS 99236

Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, 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, 85 minutes must be met or exceeded.

Facilitymedian $263 · 10th–90th $209–$3240%20%10th90th$263$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
$208.93 / $263.03 / $316.23
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $645.65 / $2,951.21
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $218.78 / $616.60
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $338.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $645.65 / $2,951.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78