go back

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
$52.48 / $100.00 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $70.79 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $114.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $83.18 / $120.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $87.10 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $104.71 / $162.18
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $72.44 / $131.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $109.65 / $512.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.28 / $81.28 / $81.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $91.20 / $131.83