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Maine 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 $100–$1510%20%10th90th$115Professionalmedian $135 · 10th–90th $100–$1910%10%10th90th$135$100.0$500.0$2.0K$10.0K

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
$100.00 / $114.82 / $151.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $165.96 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $257.04
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $173.78 / $204.17
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $114.82 / $165.96
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $181.97 / $223.87