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Nursing Home Follow-Up Visit, Most Involved

Massachusetts rates for HCPCS 99310

A follow-up visit to a resident of a nursing facility by their doctor or advanced practice clinician. This is the most involved level of such visits, used when the resident has developed a significant new problem or has become markedly worse and needs a thorough reassessment. It covers examining the resident, reviewing results and medicines, and revising the plan of care.

Rates data updated July 2026.

How much does Nursing Home Follow-Up Visit, Most Involved cost?

$166

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $166 from a physician practice, and about $166 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$166$141 to $195
FacilityA hospital or hospital-owned outpatient department$166$141 to $195

How much rates vary

Facilitymedian $166 · 10th to 90th $132 to $219Professionalmedian $166 · 10th to 90th $123 to $295
$100$200$500facility $166professional $166

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$165.96
Typical High
$204.17
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$151.36
Typical High
$263.03
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$338.84
Typical High
$831.76
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$177.83
Typical High
$371.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$223.87
Typical High
$467.74
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$165.96
Typical High
$302.00
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$162.18
Typical High
$263.03
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$194.98
Typical High
$338.84
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$338.84
Typical High
$831.76
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$177.83
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$173.78
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$380.19

Where Massachusetts sits

The same service costs 2.4 times more in Alaska than in Indiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 5th of 51

$166

AK $269IN $112

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.