Assisted Living Visit, New Patient, High Complexity

Nationwide rates for HCPCS 99328

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. This is the highest level, used when the patient is unstable or has serious conditions that interact, so the assessment and the decisions are extensive.

Rates data updated July 2026.

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

$525

Typical negotiated rate. Nationwide, July 2026.

Insurers have agreed to pay about $525 for this service. The price depends on where it is billed: about $479 from a physician practice, and about $724 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 25 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed by	Who charges it	Typical	Range
Physician practiceA doctor's office, clinic or independent provider	A doctor's office, clinic or independent provider	$479	$380 to $676
FacilityA hospital or hospital-owned outpatient department	A hospital or hospital-owned outpatient department	$724	$490 to $851

How much rates vary

Facilitymedian $724 · 10th to 90th $309 to $1,622Professionalmedian $479 · 10th to 90th $257 to $813

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High
BCBS Setting Facility Modifier Global Typical Low $457.09 Median $794.33 Typical High $2,570.40	Facility	Global	$457.09	$794.33	$2,570.40
Cigna Setting Facility Modifier Global Typical Low $549.54 Median $724.44 Typical High $2,041.74	Facility	Global	$549.54	$724.44	$2,041.74
Cigna Setting Professional Modifier Global Typical Low $380.19 Median $478.63 Typical High $870.96	Professional	Global	$380.19	$478.63	$870.96
United Setting Facility Modifier Global Typical Low $117.49 Median $199.53 Typical High $218.78	Facility	Global	$117.49	$199.53	$218.78
United Setting Professional Modifier Global Typical Low $30.90 Median $50.12 Typical High $295.12	Professional	Global	$30.90	$50.12	$295.12

What it costs in each state

The same service costs 27.5 times more in North Carolina than in South Carolina. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

NC $832SC $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.