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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
$73.25 / $80.63 / $124.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.25 / $73.25 / $89.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.40 / $84.66 / $174.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.39 / $110.50 / $168.21
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.07 / $76.91 / $96.76
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.52 / $70.52 / $90.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.63 / $109.61 / $171.61
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.30 / $365.94 / $365.94
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.92 / $462.92 / $512.83