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New York rates for HCPCS 99318

Evaluation and management of a patient involving an annual nursing facility assessment, which requires these 3 key components: A detailed interval history; A comprehensive examination; and Medical decision making that is of low to moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is stable, recovering, or improving. Typically, 30 minutes are spent at the bedside and on the patient's facility floor or unit.

Facilitymedian $135 · 10th–90th $44–$1350%50%10th$135Professionalmedian $69 · 10th–90th $32–$1350%20%10th90th$69$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $43.65 / $69.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $33.88 / $109.65