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California rates for HCPCS 99424

Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or death, the condition requires development, monitoring, or revision of disease-specific care plan, the condition requires frequent adjustments in the medication regimen and/or the management of the condition is unusually complex due to comorbidities, ongoing communication and care coordination between relevant practitioners furnishing care; first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.08 / $76.14 / $85.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.23 / $74.84 / $107.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.42 / $68.22 / $179.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $77.09 / $144.00
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.70 / $85.30 / $126.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.31 / $97.59 / $175.13
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.31 / $91.36 / $114.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.93 / $80.95 / $143.16
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.57 / $365.94 / $365.94
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.92 / $462.92 / $512.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.30 / $84.81 / $115.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.31 / $97.89 / $186.86
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.47 / $92.25 / $121.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.48 / $94.71 / $234.84