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Indiana 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 $83 · 10th–90th $55–$1000%20%10th90th$83Professionalmedian $95 · 10th–90th $54–$1820%5%10%10th90th$95$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
$51.29 / $74.13 / $93.33
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $97.72 / $186.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $162.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $85.11 / $131.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $85.11 / $109.65
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $83.18 / $104.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $81.28 / $128.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $93.33 / $104.71
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $77.62 / $112.20