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Pennsylvania 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
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.60 / $82.00 / $118.30
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.60 / $48.60 / $48.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00