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Washington 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.

Facilitymedian $71 · 10th–90th $43–$1150%10%10th90th$71Professionalmedian $72 · 10th–90th $43–$1120%10%10th90th$72$50.0$100.0

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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $70.79 / $114.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $75.86 / $114.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $93.33 / $93.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $67.61 / $107.15