go back

Texas 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 $100–$1410%50%10th90th$105Professionalmedian $115 · 10th–90th $100–$1580%20%10th90th$115$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$100.00 / $104.71 / $141.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $114.82 / $154.88
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $109.65 / $151.36
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,388.44 / $4,168.69
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $107.15 / $125.89
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $144.54 / $204.17
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $794.33
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $190.55
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $120.23 / $190.55
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $173.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $141.25 / $199.53
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $165.96