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Pennsylvania rates for HCPCS 99349

Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.

Professionalmedian $115 · 10th–90th $87–$1910%10%20%10th90th$115$100.0$200.0

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
$87.10 / $112.20 / $190.55
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $131.83 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $208.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $190.55 / $223.87
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $114.82 / $177.83
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $125.89 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $218.78