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Tennessee 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 $89 · 10th–90th $58–$2190%20%10th90th$89Professionalmedian $115 · 10th–90th $58–$1860%10%10th90th$115$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
$57.54 / $85.11 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $114.82 / $181.97
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $74.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $97.72 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $97.72 / $141.25
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $79.43 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$51.29 / $66.07 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $151.36