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Montana 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 $229 · 10th–90th $214–$64,5650%50%10th90th$229Professionalmedian $126 · 10th–90th $102–$2090%20%40%10th90th$126$100.0$500.0$2.0K$10.0K$50.0K

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
$112.20 / $112.20 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64,565.42 / $77,624.71 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $177.83 / $346.74
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $229.09 / $257.04
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $229.09 / $257.04
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $245.47
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $302.00
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
$109.65 / $213.80 / $234.42