go back

South Carolina 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 $93 · 10th–90th $83–$1120%20%10th90th$93Professionalmedian $126 · 10th–90th $93–$2190%20%10th90th$126$50.0$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
$83.18 / $93.33 / $112.20
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $223.87
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $114.82 / $134.90
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $165.96 / $223.87
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $363.08
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $199.53