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Michigan rates for HCPCS 99354

Prolonged service(s) in the outpatient setting requiring direct patient contact beyond the time of the usual service; first hour (List separately in addition to code for outpatient Evaluation and Management or psychotherapy service, except with office or other outpatient services [99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215])

Facilitymedian $102 · 10th–90th $81–$1410%20%10th90th$102Professionalmedian $126 · 10th–90th $91–$1780%10%20%10th90th$126$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $338.84 / $549.54
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $109.65 / $251.19
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $125.89 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $117.49 / $158.49