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Massachusetts 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 $112 · 10th–90th $89–$1510%20%10th90th$112Professionalmedian $105 · 10th–90th $76–$2090%20%10th90th$105$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$89.13 / $112.20 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $199.53
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$87.10 / $87.10 / $87.10
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $234.42 / $562.34
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $257.04
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $281.84
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $117.49 / $213.80
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $114.82 / $181.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $138.04 / $234.42
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $234.42 / $562.34
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $117.49 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $257.04