go back

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
$63.60 / $70.06 / $86.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.50 / $69.83 / $81.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.80 / $21.80 / $68.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.80 / $29.76 / $63.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.49 / $66.76 / $77.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.02 / $74.61 / $89.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.66 / $90.00 / $118.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.48 / $87.31 / $119.78