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Georgia 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
$57.54 / $61.66 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $70.79 / $100.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $81.28 / $107.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $77.62 / $87.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $109.65 / $169.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $89.13 / $177.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $97.72 / $165.96