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Pennsylvania rates for HCPCS 99345

Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.

Professionalmedian $186 · 10th–90th $138–$2450%10%20%10th90th$186$100.0$200.0$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
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $186.21 / $245.47
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $331.13
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $208.93 / $346.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $229.09 / $354.81
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $309.03 / $354.81
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $186.21 / $245.47
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $199.53 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $234.42 / $371.54