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Washington 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 $234 · 10th–90th $141–$3090%20%10th90th$234Professionalmedian $141 · 10th–90th $105–$2630%10%20%10th90th$141$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
$141.25 / $234.42 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $134.90 / $234.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $128.82 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $234.42 / $363.08
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $245.47 / $263.03
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $173.78
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $363.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $128.82 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $165.96 / $323.59
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $169.82 / $295.12