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Pennsylvania 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 $132 · 10th–90th $132–$1320%50%100%$132Professionalmedian $166 · 10th–90th $87–$2450%10%20%10th90th$166$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
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $371.54 / $575.44
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $93.33 / $162.18
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $131.83 / $131.83
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $190.55 / $245.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $158.49