go back

New York 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 $0 · 10th–90th $0–$1700%50%90th$0Professionalmedian $129 · 10th–90th $83–$1820%20%10th90th$129$0.1$0.5$2.0$10.0$50.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $154.88
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $489.78 / $588.84
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $0.10
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $112.20 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $165.96