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North Carolina 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
$72.44 / $79.43 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $72.44 / $104.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $79.43 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $77.62 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $109.65 / $162.18
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $75.86 / $97.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $95.50 / $147.91
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86