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New Jersey 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 $132 · 10th–90th $72–$1740%10%20%10th90th$132Professionalmedian $126 · 10th–90th $95–$2090%10%20%10th90th$126$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
$72.44 / $131.83 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $218.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $141.25 / $169.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $169.82 / $239.88
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $131.83 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $120.23 / $151.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $117.49 / $181.97