Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes in Iowa
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Iowa Pricing in Context
In Iowa, CPT code 99305 (Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes) carries an average Medicare payment of $91.50 — 10% below the national benchmark of $101.22. 582 providers across the state submitted claims for this procedure in 2023, performing 6.9K total services. Individual payments in IA ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.
The average billed charge in Iowa is $280.76, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Iowa sits below the national Medicare average, commercial rates in the state may also run lower than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Emergency procedures, the estimated commercial insurance price in Iowa lands near $246.79, with self-pay cash prices typically around $167.50. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.
Frequently Asked Questions
How much does Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes cost in Iowa?
The average Medicare payment for Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes in Iowa is $91.50, which is 10% below the national average of $101.22. Providers in IA typically bill $280.76 for this procedure.
What does Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes cost with insurance in Iowa?
With commercial insurance in Iowa, Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes costs an estimated $246.79. Without insurance, the estimated cash price is $167.50. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes in Iowa?
582 providers in Iowa billed Medicare for Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes in 2023, performing 6.9K total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes cheaper in Iowa than the national average?
Yes — Initial Nursing Facility Care With Moderate Level Of Medical Decision Making, Per Day, If Using Time, At Least 35 Minutes costs 10% below the national average in Iowa. The state average Medicare payment is $91.50 compared to $101.22 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.