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Maryland 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
$86.33 / $86.33 / $95.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.50 / $71.37 / $86.24
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.95 / $76.95 / $94.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.80 / $89.48 / $150.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.48 / $79.56 / $113.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.31 / $96.92 / $157.85
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.02 / $98.15 / $122.72