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New York 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 $182 · 10th–90th $123–$3020%20%10th90th$182Professionalmedian $138 · 10th–90th $98–$2690%20%10th90th$138$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
$134.90 / $186.21 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $141.25 / $263.03
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$30.20 / $125.89 / $288.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.79 / $114.82 / $251.19
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $50,118.72 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $181.97 / $707.95
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $151.36 / $363.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $489.78
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $144.54 / $144.54
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $117.49 / $169.82
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $229.09 / $489.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $165.96 / $302.00
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $144.54 / $257.04
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $123.03 / $380.19