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Indiana 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 $120 · 10th–90th $78–$1860%10%10th90th$120Professionalmedian $120 · 10th–90th $83–$2000%10%10th90th$120$100.0$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
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $112.20 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $114.82 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $104.71 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $120.23 / $234.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $120.23 / $239.88
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $134.90 / $169.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $138.04 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $125.89 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $177.83