go back

South Dakota 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 $105 · 10th–90th $91–$1410%20%10th90th$105Professionalmedian $126 · 10th–90th $100–$2570%10%20%10th90th$126$100.0$200.0

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
$91.20 / $104.71 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $125.89 / $173.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $275.42 / $302.00
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $165.96 / $269.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $269.15
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $213.80 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $234.42 / $309.03