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Virginia 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 $110 · 10th–90th $93–$4680%10%20%10th90th$110Professionalmedian $126 · 10th–90th $95–$1910%20%10th90th$126$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$93.33 / $109.65 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $190.55
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $128.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $144.54 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $186.21 / $204.17
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$117.49 / $147.91 / $234.42
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $169.82 / $10,000.00
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $169.82 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$53.70 / $53.70 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $134.90 / $234.42