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Nebraska 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
$69.23 / $69.23 / $76.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.25 / $70.63 / $81.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.38 / $184.38 / $184.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.08 / $129.44 / $262.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.01 / $119.34 / $159.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.60 / $156.65 / $195.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.31 / $82.16 / $141.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.85 / $159.00 / $462.92
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.40 / $145.69 / $186.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.40 / $145.69 / $186.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.16 / $138.03 / $170.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.48 / $159.00 / $200.34