go back

New York 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
$154.79 / $223.95 / $308.27
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.04 / $300.04 / $300.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.08 / $238.08 / $238.08
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.00 / $240.79 / $513.70
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.08 / $555.00 / $74,999.25
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.21 / $200.21 / $770.51