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Assisted Living Visit, New Patient, Low Complexity

Pennsylvania 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?

$69.18

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $69.18 for this service. Most negotiated rates run $69.18 to $75.86.

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 $66 · 10th to 90th $66 to $66Professionalmedian $69 · 10th to 90th $69 to $76
facility $66professional $69

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
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$66.07
Median
$66.07
Typical High
$66.07
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$75.86
Typical High
$75.86
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$69.18
Typical High
$69.18

Where Pennsylvania 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.

Pennsylvania· 30th of 34

$69.18

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.