Initial nursing facility visit, moderate complexity

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-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes

Payers reporting CPT 99305

Payer pricing summary

Low

Average

$5.4k

Median

$172

High

$106.1k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Medica fee schedule · outpatient · +16 other terms	25	$228	$342	$173	50%	1–10	$89 – $596
2	Humana fee schedule · outpatient · +26 other terms	157	$157	$426	$778	183%	—	$22 – $8.3k
3	UnitedHealthcare fee schedule · both · +27 other terms	132	$186	$155	$93	60%	—	$0 – $521
4	Aetna fee schedule · outpatient · +29 other terms	125	$128	$349	$1.0k	301%	—	$20 – $8.4k
5	Anthem fee schedule · outpatient · +20 other terms	67	$127	$318	$345	108%	—	$22 – $1.6k
6	Cigna fee schedule · outpatient · +21 other terms	66	$146	$151	$47	31%	—	$77 – $389
7	Blue Cross Blue Shield fee schedule · outpatient · +26 other terms	64	$204	$262	$206	79%	—	$0 – $834
8	WellCare fee schedule · both · +21 other terms	49	$124	$134	$23	17%	—	$66 – $211
9	Molina professional · fee schedule · outpatient · +21 other terms	42	$130	$119	$21	18%	—	$57 – $176
10	Kaiser fee schedule · outpatient · +17 other terms	34	$128	$127	$55	43%	—	$22 – $268
11	Optum professional · fee schedule · outpatient · +15 other terms	26	$127	$122	$24	19%	—	$61 – $187
12	Ambetter fee schedule · both · +14 other terms	25	$211	$217	$42	19%	—	$35 – $251
13	Regence professional · fee schedule · outpatient · +10 other terms	24	$130	$144	$35	25%	—	$111 – $327
14	Devoted fee schedule · outpatient · +7 other terms	21	$130	$129	$1	1%	—	$128 – $130
15	Caresource facility · case rate · outpatient · +11 other terms	20	$69	$109	$74	68%	—	$42 – $273
16	MultiPlan professional · fee schedule · both · +16 other terms	19	$219	$236	$63	27%	—	$86 – $368
17	Medicare fee schedule · outpatient · +11 other terms	18	$128	$125	$3	2%	—	$120 – $130
18	Wellmark fee schedule · both · +12 other terms	18	$172	$173	$27	16%	—	$121 – $194
19	Highmark fee schedule · outpatient · +12 other terms	16	$141	$140	$43	31%	—	$39 – $436
20	Tricare fee schedule · both · +16 other terms	16	$122	$121	$28	23%	—	$35 – $187
21	Ucare professional · fee schedule · outpatient · +9 other terms	16	$121	$121	$24	20%	—	$93 – $204
22	Medicaid fee schedule · outpatient · +9 other terms	15	$57	$59	$15	25%	—	$47 – $106
23	Aetna Better Health professional · fee schedule · both · +10 other terms	14	$97	$107	$28	26%	—	$66 – $161
24	Amerihealth Caritas fee schedule · both · +6 other terms	14	$117	$115	$20	17%	—	$55 – $162
25	First Health professional · fee schedule · both · +16 other terms	14	$149	$164	$75	46%	—	$57 – $376

Page 1 of 3 · 58 payers