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Missouri 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
$53.71 / $73.37 / $117.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.27 / $72.17 / $90.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.92 / $82.30 / $126.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.50 / $103.86 / $152.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.93 / $72.17 / $132.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.93 / $109.08 / $512.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.84 / $102.06 / $143.81