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Pennsylvania 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 $170 · 10th–90th $162–$5750%50%10th90th$170$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$162.18 / $169.82 / $295.12
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $263.03
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $165.96 / $208.93
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,466.84 / $5,623.41
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $12.02 / $245.47