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Kentucky 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 $115 · 10th–90th $85–$1740%20%10th90th$115Professionalmedian $120 · 10th–90th $87–$1740%10%10th90th$120$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
$85.11 / $114.82 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $123.03 / $165.96
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $173.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $93.33 / $131.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $147.91 / $194.98
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $147.91 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $616.60 / $616.60
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
$102.33 / $114.82 / $173.78