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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
$75.86 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $72.44 / $100.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $114.82 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $112.20 / $112.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $112.20 / $117.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $91.20 / $154.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $204.17 / $239.88
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $75.86 / $104.71
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $100.00 / $154.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.86 / $91.20 / $117.49