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Nationwide rates for HCPCS 99342

Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $93 · 10th–90th $56–$3550%10%10th90th$93Professionalmedian $71 · 10th–90th $52–$1070%20%10th90th$71$1.0$5.0$20.0$100.0$500.0

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $77.62 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $69.18 / $97.72
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $87.10 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $102.33 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $102.33 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $89.13 / $95.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $89.13 / $154.88
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$93.33 / $93.33 / $93.33

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