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Kentucky 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
$59.16 / $73.43 / $112.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.16 / $70.06 / $85.45
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.37 / $78.37 / $78.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.58 / $57.59 / $73.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.79 / $79.37 / $98.57
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.79 / $86.46 / $114.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.60 / $99.60 / $99.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.56 / $87.08 / $163.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $80.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.98 / $90.48 / $133.78