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Illinois rates for HCPCS 99375

Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, Alzheimer's facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication (including telephone calls) for purposes of assessment or care decisions with health care professional(s), family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care, integration of new information into the medical treatment plan and/or adjustment of medical therapy, within a calendar month; 30 minutes or more

Facilitymedian $138 · 10th–90th $138–$1620%20%40%90th$138Professionalmedian $85 · 10th–90th $69–$1580%20%10th90th$85$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $81.28 / $125.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $91.20 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $120.23 / $169.82
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $269.15 / $316.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $114.82 / $173.78