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Nationwide rates for HCPCS 99251

Inpatient 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, 20 minutes are spent at the bedside and on the patient's hospital floor or unit.

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $158.49 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $151.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $45.71 / $53.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $51.29 / $81.28

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