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Ohio 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 $120 · 10th–90th $100–$2000%20%10th90th$120Professionalmedian $120 · 10th–90th $89–$1860%10%20%10th90th$120$2.0$10.0$50.0$200.0

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
$100.00 / $120.23 / $199.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $120.23 / $181.97
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
$117.49 / $138.04 / $158.49
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$117.49 / $117.49 / $123.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $117.49 / $218.78
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $302.00
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $120.23 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $186.21 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $151.36 / $213.80
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88