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Ohio rates for HCPCS 99306

Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 50 minutes must be met or exceeded.

Facilitymedian $141 · 10th–90th $117–$2820%20%10th90th$141Professionalmedian $145 · 10th–90th $107–$2290%10%10th90th$145$2.0$10.0$50.0$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
$117.49 / $141.25 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $144.54 / $229.09
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$134.90 / $158.49 / $186.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $251.19
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $208.93 / $363.08
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $151.36 / $309.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $229.09 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $269.15