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Disability Evaluation by the Treating Doctor

South Dakota rates for HCPCS 99455

A dedicated visit in which the doctor already treating the patient assesses a work-related injury or disability claim: reviewing the history and records, examining the patient, forming an opinion on capability and restrictions, and completing the required reports and forms. It is separate from ordinary treatment of the condition itself.

Rates data updated July 2026.

Facilitymedian $135 · 10th–90th $85$2140%20%10th90th$135Professionalmedian $85 · 10th–90th $85$850%50%$85$100.0$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
Aetna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$85.11
Typical High
$85.11
Medica
Setting
Facility
Modifier
Global
Typical Low
$72.44
Median
$134.90
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36