CPT 99242

Office/Outpatient Services

Current code17 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 99242 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Capital Medical CenterOlympiaFile dated 2026-08-27———
Cascade Medical CenterLeavenworth$211 – $3174 plans$303$379
Coulee Medical CenterGrand Coulee—$302$336
Island HospitalAnacortes$57.50 – $1031 plan$115 – $206$115 – $206
Mary Bridge Children's HospitalTacomaFile dated 2026-08-27———
MultiCare Auburn Medical CenterAuburnFile dated 2026-08-27———
MultiCare Covington Medical CenterCovingtonFile dated 2026-08-27———
MultiCare Valley HospitalSpokane ValleyFile dated 2026-08-27———
Overlake Hospital Medical Center & ClinicsBellevueFile dated 2026-04-01———
PeaceHealth Southwest Medical CenteVancouver—$111$171
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$113$161
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$138$265
Seattle Children's HospitalSeattle$44.24 – $47.257 plans$172$172
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27———
Three Rivers HospitalBrewster$29.051 planDoctor’s fee: $126 – $156$41.50Doctor’s fee: $181 – $223$41.50Doctor’s fee: $181 – $223
WhidbeyHealth Medical CenterCoupeville—$215$215
Yakima Valley MemorialYakimaFile dated 2026-08-27———

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.