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California 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 $158 · 10th–90th $129–$4070%20%40%10th90th$158Professionalmedian $126 · 10th–90th $102–$2140%20%40%10th90th$126$1.0$5.0$20.0$100.0$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
$107.15 / $120.23 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $194.98
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $147.91 / $147.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $162.18 / $407.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $151.36 / $338.84
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $162.18 / $398.11
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $151.36 / $181.97
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $151.36 / $281.84
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $190.55
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $181.97 / $239.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $154.88 / $363.08
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $112.20 / $151.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $169.82 / $467.74