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Virginia 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 $26 · 10th–90th $19–$680%10%20%10th90th$26Professionalmedian $52 · 10th–90th $23–$1120%5%10th90th$52$20.0$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
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $95.50 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $194.98 / $389.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $125.89 / $138.04
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $30.20 / $39.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $25.12 / $67.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $51.29 / $102.33