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New Mexico 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 $102 · 10th–90th $55–$1320%10%20%10th90th$102Professionalmedian $123 · 10th–90th $49–$1740%10%10th90th$123$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
$54.95 / $109.65 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $123.03 / $173.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $87.10 / $134.90
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $112.20
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $102.33 / $177.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $104.71 / $138.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $104.71 / $131.83