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Assisted Living Visit, New Patient, Low Complexity

New York rates for HCPCS 99325

A first visit by a doctor or other qualified provider to a patient living in an assisted living residence, rest home, or similar place that provides housing and personal care rather than skilled nursing. It covers a low level of complexity, with a fuller history and examination than the briefest first visit for a problem that is not severe.

Rates data updated July 2026.

How much does Assisted Living Visit, New Patient, Low Complexity cost?

$105

Typical facility fee. In New York, July 2026.

Insurers have agreed to pay about $105 for this service. Most negotiated rates run $0.10 to $110.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $110Professionalmedian $110 · 10th to 90th $110 to $110
$0.1$1$10$100facility $0professional $110

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$0.10
Median
$0.10
Typical High
$0.10
United
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$93.33
Typical High
$177.83

Where New York sits

The same service costs 10.7 times more in North Carolina than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New York· 23rd of 34

$105

NC $324SC $30.20

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.