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New York 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 $126 · 10th–90th $81–$2450%20%10th90th$126Professionalmedian $95 · 10th–90th $66–$1860%20%10th90th$95$0.1$1.0$10.0$100.0$1.0K$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
$81.28 / $128.82 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $97.72 / $186.21
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$20.42 / $102.33 / $102.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $75.86 / $173.78
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $125.89 / $501.19
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $104.71 / $251.19
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $338.84
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $100.00 / $100.00
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $79.43 / $120.23
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $109.65 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $338.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $117.49 / $234.42
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $100.00 / $190.55
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$31.62 / $85.11 / $302.00