APC 5863

Partial hospitalization program day

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Partial Hospitalization (

Payers reporting APC 5863

Payer pricing summary

Low

$141

Average

$359

Median

$324

High

$892

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +2 other terms	174	$320	$316	$18	6%	—	$259 – $404
2	Humana fee schedule · outpatient · +2 other terms	161	$314	$328	$96	29%	—	$259 – $1.3k
3	Aetna fee schedule · outpatient · +2 other terms	155	$320	$319	$33	10%	—	$259 – $471
4	WellCare fee schedule · outpatient · +1 other terms	131	$323	$324	$16	5%	—	$269 – $396
5	Blue Cross Blue Shield fee schedule · outpatient · +2 other terms	125	$314	$314	$28	9%	—	$257 – $410
6	Devoted fee schedule · outpatient	122	$314	$314	$9	3%	—	$274 – $330
7	Cigna Healthspring fee schedule · outpatient	110	$330	$323	$14	4%	—	$314 – $349
8	Molina fee schedule · outpatient · +2 other terms	69	$462	$444	$177	40%	—	$269 – $824
9	Superior Healthplan fee schedule · outpatient	43	$330	$330	$2	0%	—	$330 – $343
10	Anthem fee schedule · outpatient · +1 other terms	31	$330	$315	$29	9%	—	$269 – $402
11	Oscar fee schedule · outpatient	27	$308	$339	$49	15%	—	$308 – $471
12	Amerihealth Caritas fee schedule · outpatient	17	$392	$383	$19	5%	—	$341 – $392
13	Cigna fee schedule · outpatient · +1 other terms	15	$302	$297	$21	7%	—	$269 – $319
14	Clover fee schedule · outpatient · +1 other terms	15	$330	$316	$16	5%	—	$288 – $330
15	Kaiser fee schedule · outpatient · +1 other terms	15	$336	$328	$20	6%	—	$275 – $336
16	Medicare case rate · outpatient	8	$245	$248	$6	2%	—	$245 – $263
17	Optum fee schedule · outpatient	8	$314	$464	$228	49%	—	$253 – $785
18	Ambetter case rate · outpatient · +2 other terms	7	$441	$443	$4	1%	—	$441 – $452
19	Tricare case rate · outpatient	7	$235	$235	—	—	—	$235 – $235
20	Excellus case rate · outpatient	5	$887	$892	$229	26%	—	$550 – $1.3k
21	Highmark case rate · outpatient	5	$390	$555	$208	38%	—	$390 – $917
22	Sanford Health Plan case rate · outpatient	3	$390	$393	$40	10%	—	$326 – $449
23	Aetna Better Health facility · case rate · outpatient	1	$208	$208	$67	32%	—	$141 – $275
24	Magellan fee schedule · outpatient	1	$305	$305	—	—	—	$305 – $305
25	Medicaid facility · case rate · outpatient	1	$141	$141	—	—	—	$141 – $141