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Missouri 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 $112 · 10th–90th $79–$2090%10%10th90th$112Professionalmedian $115 · 10th–90th $79–$1910%10%10th90th$115$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
$79.43 / $104.71 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $128.82 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $208.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $239.88 / $602.56
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $131.83 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $165.96 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $131.83 / $208.93