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Vermont 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.

Professionalmedian $89 · 10th–90th $58–$1580%20%10th90th$89$0.1$0.5$2.0$10.0$50.0$200.0

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
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $83.18 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $169.82
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.05 / $0.05 / $0.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $107.15 / $173.78