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Michigan 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 $158 · 10th–90th $117–$1580%50%10th$158Professionalmedian $135 · 10th–90th $105–$2240%10%20%10th90th$135$50.0$100.0$200.0$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
$117.49 / $158.49 / $158.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $199.53
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$120.23 / $125.89 / $389.05
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $144.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $263.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $229.09 / $245.47
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $251.19
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $158.49 / $346.74
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $147.91 / $229.09
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$120.23 / $123.03 / $389.05
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $190.55 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $194.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $147.91 / $208.93