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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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.72 / $255.86 / $313.77
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.35 / $644.16 / $2,676.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.53 / $135.53 / $338.83
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.27 / $454.27 / $1,005.91