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Minnesota 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.

Facilitymedian $166 · 10th–90th $74–$5890%10%20%10th90th$166Professionalmedian $120 · 10th–90th $68–$2240%5%10%10th90th$120$50.0$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $81.28 / $81.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $72.44 / $91.20
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $138.04 / $457.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $239.88
BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$75.86 / $125.89 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $302.00 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $213.80 / $354.81
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $302.00 / $588.84
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $208.93 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $91.20 / $169.82
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $181.97 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $162.18 / $269.15