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Nationwide rates for HCPCS 99442

Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion

Facilitymedian $51 · 10th–90th $23–$2090%10%10th90th$51Professionalmedian $65 · 10th–90th $27–$2090%10%10th90th$65$0.1$0.5$5.0$50.0$500.0$5.0K$50.0K

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
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $100.00 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $93.33 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $281.84 / $676.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $194.98 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.38 / $23.44 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $45.71 / $177.83

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