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Michigan 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
$76.95 / $84.55 / $84.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.09 / $73.78 / $87.93
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.37 / $83.37 / $83.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.87 / $111.05 / $111.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.95 / $111.05 / $138.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.70 / $89.35 / $156.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.95 / $82.04 / $84.55
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.29 / $80.80 / $93.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.66 / $67.28 / $94.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.63 / $95.68 / $118.74