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Iowa 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 $182 · 10th–90th $89–$2450%10%10th90th$182Professionalmedian $123 · 10th–90th $95–$2340%10%20%10th90th$123$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
$89.13 / $181.97 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $204.17
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $251.19 / $302.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $426.58
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $234.42 / $602.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $177.83 / $263.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $263.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $144.54 / $288.40
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21