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Colorado 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
$72.97 / $72.97 / $82.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.27 / $73.08 / $88.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.53 / $92.76 / $143.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.36 / $107.03 / $149.62
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.28 / $82.16 / $115.02
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.97 / $105.81 / $160.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.40 / $125.32 / $231.16