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Maryland 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 $129 · 10th–90th $115–$1510%20%10th90th$129Professionalmedian $129 · 10th–90th $95–$2240%20%10th90th$129$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
$114.82 / $128.82 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $223.87
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $114.82 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $213.80 / $257.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $162.18 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $138.04 / $229.09
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $147.91 / $223.87