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Kentucky 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 $132 · 10th–90th $98–$2000%20%40%10th90th$132Professionalmedian $126 · 10th–90th $98–$1860%10%10th90th$126$1.0$5.0$20.0$100.0$500.0

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
$97.72 / $131.83 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $128.82 / $186.21
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$112.20 / $112.20 / $112.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $97.72 / $138.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $229.09
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $169.82 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $707.95 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $117.49 / $181.97