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Extra Non-Visit Care Time, First Hour

Massachusetts rates for HCPCS 99358

This covers the first hour of extra time a clinician spends working on a patient's care outside of a face-to-face visit, for example reviewing extensive medical records, coordinating with other specialists, or preparing a complex care plan. It applies when this extra work goes well beyond what's typically expected around a regular appointment. The time doesn't include being in the room with the patient.

Rates data updated July 2026.

How much does Extra Non-Visit Care Time, First Hour cost?

$129

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $129 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $105 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$135$100 to $200
FacilityA hospital or hospital-owned outpatient department$105$100 to $141

How much rates vary

Facilitymedian $105 · 10th to 90th $85 to $229Professionalmedian $135 · 10th to 90th $89 to $245
$50$100$200$500$1K$2K$5Kfacility $105professional $135

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$117.49
Typical High
$141.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$104.71
Typical High
$288.40
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$218.78
Typical High
$323.59
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$141.25
Typical High
$676.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$229.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$141.25
Typical High
$213.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$158.49
Typical High
$229.09
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$93.33
Typical High
$245.47
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$89.13
Typical High
$151.36
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$91.20
Median
$154.88
Typical High
$234.42
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$218.78
Typical High
$323.59
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$141.25
Typical High
$676.08
United
Setting
Facility
Modifier
Global
Typical Low
$91.20
Median
$91.20
Typical High
$199.53
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$162.18
Typical High
$251.19

Where Massachusetts sits

The same service costs 2.6 times more in Alaska than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 16th of 51

$129

AK $214AL $81.28

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.