go back

New Jersey rates for HCPCS 99241

Office consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.

Facilitymedian $26 · 10th–90th $26–$260%50%100%$26Professionalmedian $62 · 10th–90th $47–$1200%10%20%10th90th$62$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.70 / $25.70 / $25.70
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$36.31 / $47.86 / $47.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $63.10 / $120.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $41.69 / $63.10