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South Dakota 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 $162 · 10th–90th $145–$3240%20%10th90th$162Professionalmedian $355 · 10th–90th $257–$4170%20%10th90th$355$200.0$500.0

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
$144.54 / $162.18 / $190.55
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $309.03 / $416.87
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $416.87 / $416.87
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $354.81 / $416.87