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Nationwide rates for HCPCS 99310

Subsequent 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, 45 minutes must be met or exceeded.

Facilitymedian $148 · 10th–90th $105–$2820%50%10th90th$148Professionalmedian $135 · 10th–90th $102–$2290%50%10th90th$135$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$102.33 / $131.83 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $199.53
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$30.20 / $125.89 / $208.93
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $169.82 / $426.58
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $141.25 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $537.03 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $245.47 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $151.36 / $295.12
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88

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