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Arizona rates for HCPCS 99305

Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.

Facilitymedian $126 · 10th–90th $91–$6030%20%10th90th$126Professionalmedian $129 · 10th–90th $95–$2820%10%10th90th$129$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $128.82 / $281.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $147.91
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $125.89 / $213.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $602.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $131.83 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $123.03 / $218.78