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Connecticut 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 $229 · 10th–90th $117–$2290%50%10th$229Professionalmedian $135 · 10th–90th $98–$2820%10%20%10th90th$135$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
$117.49 / $229.09 / $229.09
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $134.90 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $162.18 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $190.55 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $144.54 / $223.87