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Illinois rates for HCPCS 99309

Subsequent 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, 30 minutes must be met or exceeded.

Facilitymedian $129 · 10th–90th $71–$2040%10%10th90th$129Professionalmedian $95 · 10th–90th $71–$1740%10%10th90th$95$20.0$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
$67.61 / $104.71 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $93.33 / $173.78
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$20.42 / $91.20 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $102.33 / $104.71
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $380.19 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $123.03 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $141.25 / $177.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $275.42
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $131.83 / $141.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $173.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $114.82 / $169.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $107.15 / $162.18