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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
$87.10 / $87.10 / $95.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.88 / $70.79 / $85.11
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $79.43 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.07 / $91.20 / $151.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $72.44 / $104.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $87.10 / $120.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $91.20 / $147.91
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $123.03 / $141.25