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Indiana 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
$70.79 / $87.10 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $70.79 / $93.33
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $104.71 / $114.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.88 / $21.88 / $61.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $33.88 / $70.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.57 / $69.18 / $75.86
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $64.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $83.18 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $89.13 / $117.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $83.18 / $120.23