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Assisted Living Visit, New Patient, Moderate

Pennsylvania rates for HCPCS 99326

A first visit by a doctor or other qualified provider to a patient living in an assisted living residence, rest home, or similar place providing housing and personal care. It covers a moderate level of complexity, with a detailed history and examination and decisions about a problem of moderate severity.

Rates data updated July 2026.

How much does Assisted Living Visit, New Patient, Moderate cost?

$91.20

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $91.20 for this service. Most negotiated rates run $91.20 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 $66 · 10th to 90th $66 to $66Professionalmedian $91 · 10th to 90th $91 to $110
$100facility $66professional $91

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
$109.65
Median
$109.65
Typical High
$109.65
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$91.20

Where Pennsylvania sits

The same service costs 17.8 times more in Missouri 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· 32nd of 34

$91.20

MO $537SC $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.