What does Bcbs Ma pay for CPT 99291 in Springfield, MA?

The local peer median for CPT 99291 under Bcbs Ma in Springfield, MA is $451.05, based on 314 indexed providers. Modeled from published rates, not guaranteed.

What is the top of the local market (P90) for CPT 99291 under Bcbs Ma in Springfield, MA?

The P90, the top of the local market and Reddenda's target rate, is $482.31.

How does Bcbs Ma's rate for CPT 99291 compare to Medicare?

The Bcbs Ma local median of $451.05 is 146% of Medicare's national non-facility rate of $308.96 for CPT 99291.

Reddenda · Rate Intelligence · Springfield, MA

99291 under Bcbs Ma in Springfield, MA

Name: Bcbs Ma rates for CPT 99291 in Springfield, MA
Creator: Reddenda

Critical care, first 30-74 min · Local peer median $451.05 · High confidence

$451.05 local peer median. In the Springfield, MA market, Bcbs Ma pays a local peer median of $451.05 for CPT 99291 (Critical care, first 30-74 min), based on 314 providers in Reddenda's index of Bcbs Ma's own published in-network rates. The top of the local market, the P90 target, is $482.31, 7% above the median. A provider billed below the local median is being paid less than peers holding the identical Bcbs Ma contract in Springfield, MA for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 314 providers · 314 rate records

P10

$271.31

P25

$344.63

Median

$451.05

P75

$451.05

P90 (target)

$482.31

P10$271.31

P25$344.63

Median (P50)$451.05

P75$451.05

P90 target$482.31

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $240.63 – $774.32

The local peer median for CPT 99291 under Bcbs Ma in Springfield, MA is $451.05, drawn from 314 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Ma to publish this rate
The bottom of the local market (P10) is $271.31 and the top (P90) is $482.31; the median-to-P90 spread is $31.26.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Ma to publish this rate
The lowest published rate in this market is $240.63; the highest is $774.32.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Ma to publish this rate
This benchmark is drawn from 314 individual rate records that Bcbs Ma itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Ma to publish this rate
Medicare's national non-facility rate for CPT 99291 is $308.96, making the Bcbs Ma local median 146% of Medicare.Source: Medicare Physician Fee Schedule; the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Ma to publish this rate
45.5% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Ma to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

314 providers bill this code to this payer in this metro.

Find yourself on this curve. Enter your NPI: no account, no email, no PHI.

Free, forever, unmetered. Possession-channel verification only if you choose to claim the record; looking is always free.

See where your rate lands

This is the local market for CPT 99291 (Critical care, first 30-74 min) under Bcbs Ma in Springfield, MA. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

Run a free RateScore on your NPI → Talk to us about Bcbs Ma

Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Bcbs Ma's own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Bcbs Ma to publish this rate. Page generated 2026-08-23 23:47 UTC; the live index is queried in real time on every request.