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Pennsylvania 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.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $7.24 / $181.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $109.65 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $70.79
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $85.11 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $109.65 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $89.13 / $131.83
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $104.71 / $138.04
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $117.49 / $162.18
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.89 / $7.24 / $138.04
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $112.20 / $223.87
Optum
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $83.18 / $91.20
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.50 / $95.50 / $144.54
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $138.04 / $177.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $75.86 / $83.18
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $60.26 / $83.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $81.28 / $138.04