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Georgia rates for HCPCS 99252

Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Facilitymedian $93 · 10th–90th $62–$1350%10%10th90th$93Professionalmedian $110 · 10th–90th $58–$1780%10%10th90th$110$5.0$10.0$20.0$50.0$100.0$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
$61.66 / $91.20 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $112.20 / $177.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $117.49 / $295.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $87.10 / $138.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $95.50 / $138.04
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $85.11 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $100.00 / $151.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $95.50 / $186.21
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $144.54 / $177.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $91.20 / $173.78