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Michigan 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 $138 · 10th–90th $115–$1380%50%10th$138Professionalmedian $129 · 10th–90th $98–$2240%10%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
$102.33 / $138.04 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $125.89 / $223.87
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $131.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $194.98 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $213.80 / $223.87
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $190.55 / $346.74
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $138.04 / $346.74
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $134.90 / $208.93
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $204.17 / $346.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $138.04 / $194.98