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Pennsylvania 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 $107 · 10th–90th $102–$2450%50%10th90th$107Professionalmedian $132 · 10th–90th $100–$2400%20%10th90th$132$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$102.33 / $107.15 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $239.88
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$30.20 / $162.18 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $223.87 / $275.42
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $154.88
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $147.91 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $162.18 / $223.87
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $42.66 / $42.66
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $275.42
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $147.91
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $104.71 / $128.82
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $125.89 / $229.09
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $165.96
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $165.96
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $109.65 / $147.91
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $109.65 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $151.36 / $251.19