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Kansas 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.

Facilitymedian $72 · 10th–90th $1–$850%20%10th90th$72Professionalmedian $72 · 10th–90th $58–$910%20%40%10th90th$72$0.1$0.5$2.0$10.0$50.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $72.44 / $89.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.76 / $0.95 / $1.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.06 / $0.09 / $0.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $104.71 / $128.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $72.44 / $89.13
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $123.03 / $512.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $128.82 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $100.00 / $128.82