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Disability Evaluation by the Treating Doctor

Tennessee 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.

How much does Disability Evaluation by the Treating Doctor cost?

$85.11

Typical physician fee. In Tennessee, July 2026.

Insurers have agreed to pay about $85.11 for this service. Most negotiated rates run $85.11 to $91.20.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $170 · 10th to 90th $100 to $447Professionalmedian $85 · 10th to 90th $60 to $126
$100$200$500facility $170professional $85

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$85.11
Typical High
$125.89
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$31.62
Typical High
$75.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$208.93
Typical High
$208.93
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$245.47
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$446.68
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$109.65
Typical High
$234.42
United
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$79.43
Typical High
$208.93

Where Tennessee sits

The same service costs 3.5 times more in Illinois than in North Carolina. 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.

Tennessee· 39th of 51

$85.11

IL $263NC $75.86

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.